High syphilis but low HIV prevalence rates among pregnant women in New Caledonia

Abstract

Sexually transmitted infections have been described as one of the major health problems in several countries of the Pacific Region. The objective of the study was to estimate the prevalence of pregnant women infected with HIV and/or syphilis in New Caledonia. HIV and syphilis test results were obtained from women attending antenatal clinics. From 2008 to 2011, 3353 pregnant women were tested with a mean prevalence of active syphilis found at 5.6/100,000. No pregnant women tested positive for HIV. Despite available resources and public health strategies similar to those existing in France, active syphilis prevalence is high in New Caledonia. Surprisingly, HIV seroprevalence remains far below the figures reported in mainland countries. However, social and economic changes as well as the looming referendum on independence scheduled in 2014 may have a potential negative impact on public health resources. The need for action to control syphilis and other curable sexually transmitted infections is pressing in order to prevent further spread of HIV in New Caledonia.

Chlamydial and gonorrheal neglected sexually transmitted diseases among Pacific Islanders of the Western Pacific Region—A narrative review and call to action

“…HIV. The majority of studies up to the early 2000s found an HIV prevalence of zero to <1% among Pacific Islanders, including men and pregnant and nonpregnant women (Table 2) [6,31,32,34,[54][55][56][57][58][59][60][61]. The highest HIV prevalence was found among men and women attending an emergency department in PNG (18%) followed by FSW (10%) who had more than a 10-fold higher HIV prevalence than the general population [40,62].…”

“…Recent studies among other "higher-risk" populations found a syphilis prevalence of 6% in 2020 among MSM and TGW in PNG and 6% among FSW in Kiribati in 2018 [41,65]. One study from New Caledonia in 2013 reported that active syphilis was highest among people of Melanesian ethnicity [55].…”

“…During the 1980s and 1990s, HIV prevalence studies typically used rapid particle agglutination HIV test kits or western blot in local clinics (Table 2). In the 2000s, there was an increase in the use of ELISA tests due to their improved accuracy and adoption in higher-resource countries [31,32,54,55,69]. Since the early 2010s, more studies reported using a rapid antibody/antigen combination as the initial test followed by additional rapid antibody tests if the first result was positive [6,37,41,42,47,48,63,64].…”

“…Since the early 2010s, more studies reported using a rapid antibody/antigen combination as the initial test followed by additional rapid antibody tests if the first result was positive [6,37,41,42,47,48,63,64]. Foreign research efforts significantly expanded the capabilities for HIV testing in PICTs given the cost and limited laboratory and personnel resources in most PICTs [6,[55][56][57].…”