There is a high rate of syphilis in Burma / Myanmar, too. And no national antenatal detection and treatment programme to decrease it.
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High Rate of Syphilis Among STI Patients Are Contributing to the Spread of HIV-1 in India
S.J. Reynolds; A.R. Risbud; M.E. Shepherd; A.M. Rompalo; M.V. Ghate; S.V. Godbole; S.N. Joshi; A.D. Divekar; R.R. Ganakhedkar; R.C. Bollinger; S.M. Mehendale
Sexually Transmitted Infections: Vol. 82: P. 121-126 (04..06) - Friday, May 12, 2006
In the current study, the researchers investigated the incidence of syphilis and its association with HIV-1 infection rates among a cohort of patients attending three sexually transmitted infection (STI) clinics and one gynecology clinic in Pune, India.
From 1993 through 2000, 2,732 HIV-1 seronegative clinic patients were enrolled in an ongoing prospective cohort study of acute HIV-1 infection. "At screening and quarterly follow up visits, participants underwent HIV-1 risk reduction counseling, risk behavior assessment, and HIV/STI screening that included testing for serological evidence of syphilis by RPR with TPHA confirmation. Patients with genital ulcers were screened with dark field microscopy," the authors said.
One hundred seventy-two of the 2,324 patients who were HIV-1 and RPR seronegative at baseline were found to have clinical or laboratory evidence of syphilis during follow-up (5.4 per 100 person years, 95 percent CI 4.8 to 6.5 per 100 person years). Independent predictors derived from a Cox proportional hazards model were age less than 20, lack of formal education, recent HIV-1 infection, and earlier calendar year of follow up. Based on a median 11-month follow up, HIV-1 incidence was 5.8 per 100 person years (95 percent CI 5.0 to 6.6 per 100 person years). Adjusting for HIV risk factors using a Cox proportional hazards model found a 4.44 adjusted hazard ratio of HIV-1 infection associated with incident syphilis (95 percent CI 2.96 to 6.65; p<0.001).
"A high incidence rate of syphilis was observed among STI clinic attendees. The elevated risk of HIV-1 infection that was observed among participants with incident syphilis supports the hypothesis that syphilis enhances the sexual transmission of HIV-1 and highlights the importance of early diagnosis and treatment of syphilis," the researchers concluded.
