Prevalence of syphilis among people living with HIV and its implication for enhanced coinfection monitoring and management in China: A meta-analysis

Wu, Yang‐Chang; Zhu, Wenqian; Sun, Chengqing; Yue, Xiaoli; Zheng, Min; Fu, Gengfeng; Gong, Xiangdong

doi:10.3389/fpubh.2022.1002342

Cited by 14 publications

(10 citation statements)

References 57 publications

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“…We found no significant difference in syphilis prevalence between male and female individuals living with HIV in sub-Saharan Africa, echoing the findings of a global pooled meta-analysis among the general population by Smolak et al 25 This result is, however, in contrast to findings from other settings where a higher syphilis prevalence has been reported among men versus women living with HIV 28–30 . Our pooled syphilis prevalence among pregnant women with HIV (7.0%; 95% CI, 5.8%–8.4%) was higher than in 2 systematic reviews and meta-analyses conducted among the general population of pregnant women in sub-Saharan Africa, both of which found a pooled syphilis prevalence of 2.9%.…”

Section: Discussionsupporting

confidence: 82%

Syphilis prevalence among people living with and without HIV in sub-Saharan Africa: A systematic review and meta-analysis

Mussa,

Jarolimova,

Ryan

et al. 2024

Sexual Trans Dis

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Background Syphilis is a curable sexually transmitted infection which, untreated, is associated with significant morbidity and mortality. In people living with HIV (PLWH), syphilis carries greater risks of disease progression. We estimated syphilis prevalence among PLWH in the general population in sub-Saharan Africa and compared prevalence among PLWH and without HIV. Methods We searched for studies published 1st January 2011 to 28th March 2022 reporting syphilis prevalence among PLWH in sub-Saharan Africa (PROSPERO#: CRD42020167328). We excluded studies in high-risk subpopulations. We estimated pooled syphilis prevalence among PLWH using random effects modelling and compared prevalence to people without HIV when included in the same study. We examined influences of region, study setting, and test type in subgroup analyses. Results We identified 926 studies; 53 were included in the meta-analysis. Pooled syphilis prevalence among PLWH was 7.3% (95% CI: 6.3-8.5%). Prevalence differed by region: 3.1% (95% CI: 2.2-4.0%) in Southern, 5.5% (95% CI: 2.3-9.3%) in West/Central, and 10.5% (95% CI: 8.0-13.1%) in Eastern Africa. Prevalence also differed by study setting: 13.8% (95% CI 5.7-23.0%) in SRH/STI care, 8.7% (95% CI 5.0-12.8%) in HIV care, 7.1% (95% CI 5.8-8.5%) in antenatal care and 3.8% (95% CI 2.0-5.8%) household/community-based settings. Syphilis prevalence was higher among PLWH than without HIV (RR: 3.5, 95% CI: 2.8-4.5). Conclusions Syphilis is highly prevalent among PLWH in sub-Saharan Africa and is more common among PLWH than without HIV. Integration of syphilis screening and management into HIV care may reduce complications of HIV-syphilis co-infection among PLWH in sub-Saharan Africa.

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Section: Discussionsupporting

confidence: 82%

Syphilis prevalence among people living with and without HIV in sub-Saharan Africa: A systematic review and meta-analysis

Mussa,

Jarolimova,

Ryan

et al. 2024

Sexual Trans Dis

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“…However, when comparing the prevalence of HIV/STD among African migrants with other high-risk groups such as men who have sex with men (HIV: 5.7%, syphilis: 5.8%) and attendees of STD clinics (NG: 11.95%, CT: 12.02%) in China, the prevalence among African migrants still remains relatively low [ 15 – 17 ]. We noticed that co-infection of HIV/STDs, such as HIV and syphilis, CT and NG, were reported frequently in other studies [ 18 , 19 ], while only one co-infection (CT and HBsAg) has been observed in our study. The limited sample size of our study may lead to this discrepancy, and other potential associated factors were needed to explore in further research.…”

Section: Discussioncontrasting

confidence: 46%

HIV/STD prevalence and test uptake among african in Guangzhou, China: an analysis of data from hospital-based surveillance

Xiong,

Yang,

Zhao

et al. 2023

BMC Infect Dis

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Human immunodeficiency virus (HIV) and sexually transmitted diseases (STDs) cause substantial morbidity and mortality both in African and China. However, there is limited data available on the prevalence of HIV/STDs and the uptake of testing experience ever during in China among African migrants. A venue-based survey was conducted at a tertiary hospital in Guangzhou to investigate the prevalence of HIV/STDs through laboratory testing and identify the associated factors. A total of 200 eligible participants completed the survey and bring into the analysis from April to October 2019, and the temporary visitors were excluded. The prevalence rates of HIV, syphilis, NG, CT, and HBsAg among the participants were 1.0%, 2.5%, 1.0%, 1.5%, and 5.5%, respectively. The overall reported rate of HIV/STD testing was 37.0%, with rates of 23.0% for HIV, 16.5% for syphilis, 12.5% for NG, 6.5% for genital herpes, 5.0% for condyloma acuminata, and 2.5% for CT. HIV/STD testing was associated with living environment in Guangzhou, having medical insurance in China, and utilizing health services in China in the past year. HIV/STDs are prevalent among Africans in Guangzhou, and the epidemic is likely to spread due to a significant proportion of unprotected sexual behaviors and low rates of HIV/STD testing. Urgent interventions, including targeted health education, promotion of health service utilization, and active surveillance of HIV/STDs, are needed to reduce the risk of HIV/STD transmission.

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“…This study assessed the prevalence of current syphilis infection among virally suppressed PLWH in Zhejiang Province, China, in 2022. According to national reporting data, the annual incidence of primary and secondary syphilis have decreased from 13.44% in 2012 to 9.81% in 2015 ( 28 ), and the overall prevalence of syphilis among PLWH in China was 19.9% ( 29 ). Furthermore, according to 2011 global statistics, the mean prevalence of syphilis among PLWH was 9.5% ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Current syphilis infection in virally suppressed people living with HIV: a cross-sectional study in eastern China

He,

Pan,

Yang

et al. 2024

Front. Public Health

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BackgroundAntiretroviral therapy (ART) has been shown to reduce human immunodeficiency virus (HIV) viral replication and ultimately achieve viral suppression and eliminate HIV transmission. However, little is known about the impact of viral suppression on high-risk behaviors and sexually transmitted infections (STIs).ObjectiveThis study aimed to assess the rates of current syphilis infection in virally suppressed people living with HIV (PLWH) and whether with the duration of ART can reduce the current syphilis infection in eastern China.MethodWe conducted a cross-sectional survey of PLWH in Zhejiang Province, China, in 2022. PLWH who were on ART >6 months and were virally suppressed (viral load <50 copies/mL) were included in the study. Data were collected from the National Epidemiological Database of Zhejiang Province and all participants were tested for viral load and current syphilis. Multivariable logistic regression was used to identify risk factors associated with current syphilis infection.ResultA total of 30,744 participants were included in the analysis. 82.7% of participants were male, the mean age was 44.9 ± 14.1 years, 84.9% had received ART in a hospital setting, the mean time on ART was 5.9 ± 3.1 years and 5.6% of participants were infected with current syphilis. Multivariable logistic regression showed that being male [adjusted odds ratio (aOR): 2.12, 95% confidence interval (CI): 1.69–2.66], high level of education (aOR: 1.23, 95% CI: 1.02–1.49), homosexual route of HIV infection (aOR: 1.80, 95% CI: 1.60–2.04), non-local registered residence (aOR: 1.29, 95% CI: 1.11–1.51), had history of STIs before HIV diagnosis (aOR: 1.95, 95 % CI: 1.75–2.18) and treatment provided by a municipal hospital (aOR: 2.16, 95% CI: 1.31–3.55) were associated with increased risk of current syphilis infection. Being married (aOR: 0.67, 95% CI: 0.58–0.76) was associated with a decreased risk of current syphilis infection.ConclusionOur findings revealed a high rate of current syphilis infection among virally suppressed PLWH in eastern China. Duration of ART did not reduce the prevalence of current syphilis infection. Targeted interventions to reduce current syphilis infection should be prioritized for subgroups at higher risk.

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Prevalence of syphilis among people living with HIV and its implication for enhanced coinfection monitoring and management in China: A meta-analysis

Cited by 14 publications

References 57 publications

Syphilis prevalence among people living with and without HIV in sub-Saharan Africa: A systematic review and meta-analysis

Syphilis prevalence among people living with and without HIV in sub-Saharan Africa: A systematic review and meta-analysis

HIV/STD prevalence and test uptake among african in Guangzhou, China: an analysis of data from hospital-based surveillance

Current syphilis infection in virally suppressed people living with HIV: a cross-sectional study in eastern China

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