Syphilis and Its Correlates among Heterosexual Males Attending Sexually Transmitted Infection Clinics – Observation from a Multicity Cohort in Jiangsu Province, China

Abstract

ObjectivesTo estimate the prevalence of HIV and syphilis, incidence of syphilis and to identify the correlates of syphilis infection among heterosexual male attendees of sexually transmitted infection (STI) clinics (MSC).MethodsA cohort study of one-year duration was conducted in Yangzhou and Changzhou cities in Jiangsu province of China. The baseline survey commenced in June 2009, recruited 1225 consenting adult MSCs (609 in Yangzhou and 617 in Changzhou) through STI-clinic based convenience sampling.ResultsBaseline HIV and syphilis prevalence were 0.49% and 17.29% respectively. Syphilis incidence rate was 7.22 per 100 person-years (6.53 in Yangzhou and 7.76 in Changzhou) during the 6-month follow-up with retention fractions of 27.38% and 35.15% for Yangzhou and Changzhou respectively. Majority of the participants were middle-aged, high school educated, married, living with partners and non-migrants. Very few subjects reported recent and consistent condom-use with regular partners. Although considerable number of MSCs reported recent sexual exposure with female sex workers (FSW) and non-FSW casual partners, the proportion of reported condom use was very low during those exposures. In multivariate analyses higher age, having recent sex with FSWs and being HIV-positive were associated with higher syphilis sero-positivity while higher education was protective. In bivariate analyses, being married, divorced/widowed, official residency of the study cities and non-use of condom with regular partners predicted higher risk.ConclusionsConsidering the potential bridging role of MSCs between high and low-risk populations, effective intervention strategies among them targeting the correlates of syphilis infection are urgently called for in Jiangsu province of China.

Syphilis among men who have sex with men attending a large HIV clinic in Trinidad

“…The prevalence of syphilis in MSM living with HIV in this study was found to be higher than PLHIV (13.2%–21.0%) attending the STI clinic in Trinidad 17,18 and among heterosexual males (17.3%) attending a STI Clinic in Jiangsu Province in China. 22 Our study findings of high levels of syphilis//HIV coinfection in MSM are consistent with findings in the literature in other regions and settings. 6,9–11 The resurgence in syphilis in MSM is thought to be due to changes in sexual behavior and risk perception due to the availability of effective antiretroviral therapy 11 which suppresses the HIV viral load thereby reducing HIV transmission.…”

Higher Prevalence of Sexual Transmitted Diseases and Correlates of Genital Warts among Heterosexual Males Attending Sexually Transmitted Infection Clinics (MSCs) in Jiangmen, China: Implication for the Up-Taking of STD Related Service

“…In our study, we found only one HIV positive case, and our observed HIV prevalence was lower than another study conducted among MSCs by our team in Jiangsu[ 10 ]. The syphilis prevalence of our study was much lower as well [ 10 ]. Our study also found the prevalence of genital herpes, CT and NG among MSCs in Jiangmen was high.…”

“…A number of studies have revealed the prevalence rates of syphilis, HIV, CT, NG, HSV-2 and human papilloma virus (HPV) to be high among Chinese men who have sex with men (MSM) and female sex workers (FSWs)[ 4 – 9 ]. However, only a limited number of studies have ever investigated the prevalence of these STDs among heterosexual males attending STD clinics (MSCs) in China[ 10 ].…”

Effects of Case Management on Risky Sexual Behaviors and Syphilis Among HIV-Infected Men Who Have Sex With Men in China: A Randomized Controlled Study

“…25 Our study revealed that the observed incidence of syphilis was approximately 11.8%, with 11.3 incident cases per 100 person-years of follow-up, in the case management group and 20.5%, with 20.6 incident cases per 100 person-years of followup, in the control group. This prevalence was higher than that previously reported among heterosexual males in Jiangsu, China, 26 males in Singapore, 27 and MSM in Taiwan, China. 16 The high incidence of asymptomatic syphilis supports the need for routine annual syphilis testing for HIV-positive persons.…”