Syphilis was an important cause of pregnancy loss and infant disability, particularly among women who did not receive prenatal care or had late or inadequate treatment. These study results can inform antenatal programs on the importance of early syphilis testing and prompt and appropriate treatment. Some strategies targeted at other risk factors areas may be helpful.

Money boys (MBs) are male sex workers who sell sex to men who have sex with men (MSM). This study estimates the proportion of MBs in the Chinese MSM, compares HIV risks between MBs and non-MB MSM, and examines the associations between practicing safer sex and peer norms of condom use. Respondent-driven sampling (RDS) was used to sample 351 MSM in the city of Shenzhen in 2007. The RDS-adjusted proportion of MBs among MSM was 9%. Compared to non-MB MSM, more MBs reported having had multiple male and female sexual partners. Half of MBs and non-MB MSM had consistently used condoms. Both descriptive and subjective norms were positively associated with condom use. The MB proportion of 9% in MSM implies a relatively large population of MBs in China. The association between peer norms and consistent condom use can assist with the development of culturally competent HIV interventions that promote safer sex.

Treatment of syphilis-seropositive pregnant women with 1 course of intramuscular BPG before 28 gestational weeks is critical for prevention of CS.

Objectives: To understand the disease epidemiology of syphilis in pregnant women, and to evaluate the effectiveness of the screening and intervention programme, for the purpose of controlling mother-to-child syphilis transmission in Shenzhen, in the People's Republic of China (PRC). Methods: At the Shenzhen Center for Disease Control and Prevention (SZCDC), we used the toluidine red unheated serum test (TRUST) for the primary screening of pregnant women, and confirmed positive results with the Treponema pallidum particle agglutination (TPPA) test. We informed and treated those with positive results. For the women who chose to proceed with the pregnancy, we clinically screened their babies for congenital syphilis using the 19S-IgM FTA-Abs test. Among the 1020 infants born to these women, 92 (9.0%) were confirmed to have congenital syphilis. If we exclude the mothers who had syphilis positive babies without undergoing prenatal screening, the project's success rate for mother-to-child transmission intervention was 99.1%. Conclusions: After four years of implementation, we proved the programme to be successful in preventing mother-to-child syphilis transmission. Further work should be done to ensure the earlier screening and treatment of pregnant women. S yphilis has become a serious problem in China, particularly in pregnant women. If syphilis remains untreated in pregnancy, then miscarriages, fetal and neonatal deaths, and congenital syphilis may result.1 2 Shenzhen had almost eradicated syphilis back in the 1960s. However, syphilis cases started to re-emerge in 1983. There were fewer than 25 annual cases before 1994. From 1995 to 1999, the incidence rate increased by an average of 1.68 times each year, resulting in a five-year growth from 4.4 cases per 100 000 people in 1994, to 66.2 cases per 100 000 people in 1999. 3 The serological positive rate in pregnant women ranged from 0.4% to 0.5%, based on sera surveillance. 4 In 1996, the first congenital syphilis case was reported in the city, and in 2001 the number had increased to 36 cases. To tackle this problem, and especially to prevent mother-to-child transmission, the Shenzhen local government initiated the syphilis prevention programme for pregnant women in 2001.5 Supported by a government special fund, this programme aimed at providing free syphilis screening for all pregnant women living in Shenzhen, and if they tested positive, free follow-ups and treatment too. As recommended by the World Health Organization (WHO) in 1994, the screening instruments and treatment medicines for syphilis were simple, inexpensive, and effective. ScreeningFor pregnant women seeking prenatal care at registered medical institutions or clinics, free screenings were given based on informed consent. The sera we obtained from pregnant women were tested with the toluidine red unheated serum test (TRUST) (Rongsheng Bio-technology Limited Corporation, Shanghai, China). 8 We retested all positive results with the Treponema pallidum particle agglutination (TPPA) test (Fujirebio Inc, Jap...

HIV/STD surveillance system data are important for developing prevention and control programmes for men who have sex with men (MSM), now a core group in Chinese HIV/STD surveillance activities. MSM were recruited from different settings in Shenzhen and were tested for HIV and syphilis. A substantial prevalence of HIV and syphilis infections was found in this population. However, risk behaviours and sociodemographic characteristics varied greatly among MSM recruited from the different settings (gay sauna, gay bar and MSM clinic), suggesting that carefully considering and selecting appropriate settings to represent the MSM population is critical for developing HIV and STD surveillance and prevention programmes.