Prevalence and Factors Associated With Syphilis in People Living With HIV/AIDS in the State of Pará, Northern Brazil

Abstract

Syphilis continues to be a public health problem worldwide and its incidence has increased in people living with HIV/AIDS in recent years. This study determined the prevalence and factors associated with syphilis in people living with HIV/AIDS in the city of Belém, northern Brazil. A cross-sectional study was conducted from June to November 2018. A total of 500 people living with HIV/AIDS attended at a specialized unit of the public health network of the State of Pará were studied. Questionnaires were used to collect socio-demographic data and potential risk factors for syphilis. Blood samples were collected from all subjects and screened for syphilis using VDRL, and the seropositive were confirmed using FTA-abs. Logistic regressions were used to identify the factors associated with syphilis. Most subjects were male (56.8%), had more than 40 years (54.0%), single (63.0%), had finished high school (54.2%), had monthly income ≤1 minimum wage (72.4%), and had been born to the city of Belém (59.8%). Prevalence of syphilis was 6.4%. Eight characteristics/behaviors associated with syphilis: male, young adults, single, studied at least high school, monthly income >1 minimum wage, homosexual/bisexual, does not use or sporadically use condoms during sexual intercourse, and have had more than one sexual partner in the last three months. The prevalence of syphilis in people living with HIV/AIDS in Belém is low when compared to other Brazilian states. However, there is a need for public policies and actions to monitor, control and prevent these two sexually transmitted infections.

Upward trends of syphilis in the non-pregnant adults: A six-year report on clinical and epidemiological profile of syphilis from a tertiary care center, India

“…Syphilis and HIV co-infection is viewed as a potentially dangerous combination since both diseases negatively impact treatment response to each other. Previous studies observed serological non-response to syphilis treatment, cognitive impairment, and virological failure of ART among syphilis and HIV co-infected patients ( 21 – 23 ). Our study observed that nearly one-fourth of the study population had co-infection with HIV.…”

Prevalence and Vulnerability Factors Associated with HIV and Syphilis in Older People from Subnormal Agglomerate, Brazilian Amazon

“…The prevalence of HIV was 15.26% (38/249); syphilis was 27.71% (69/249); and HIV/syphilis co-infection was 9.24% (23/249) in aged > 50 years [24]. Among people living with HIV, the prevalence of syphilis (co-infection) was 2.1% (11/511) among those with aged over 50 years in the African [23] and 3.7% (10/270) in people aged over 40 years with HIV in Belem, Brazilian Amazon [30]. In Zimbabwe, among 222 cases of syphilis, 45% (100) were with HIV, the only factor associated with syphilis in both females and males at p < 0.001 [26].…”

“…The syphilis infection almost triples the risk of HIV acquisition [8]. Several studies have been conducted with people living with HIV, increasing the prevalence of syphilis [8,24,30]. In England, a trend over age and time showed that rates of STI were increasing in the older age groups, including those aged 45-64 years.…”

“…In a neighborhood of this subnormal agglomerate, people aged 50 and over are more likely to have low knowledge regarding STIs [31]. It is important to know the factors relevant to different populations, not only in terms of age group and sexual orientation, but also to know the scenarios in which they live, in order to propose intersectoral interventions and, in the health sector, meet the needs of the population [24][25][26][27][29][30][31].…”

“…Currently, in addition to the growing trend in the increase in the number of cases of elderly people with HIV, syphilis, and other STIs, there is also the aging of the HIV epidemic [2,8,18,[23][24][25][26][27][28][29][30][31][32][33][34]. In the United States, fifty percent of people living with HIV in the are now older than 50 years of age.…”