What underpins the decline in syphilis in Southern and Eastern Africa? An exploratory ecological analysis

Kenyon, Chris; Osbak, Kara; Chico, R Matthew

doi:10.1016/j.ijid.2014.05.014

Cited by 23 publications

(27 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We also found associations between HIV and syphilis and HIV and males reporting STIs. Similar associations have been found at the country and world region levels between the prevalence of syphilis before the HIV epidemic and peak HIV prevalence [ 18 , 29 ].…”

Section: Discussionsupporting

confidence: 76%

“…Secondly, STI prevalence from before the advent of HIV was correlated with subsequent HIV prevalence suggesting that some factor predisposed to the spread of HIV and the other STIs. Thirdly, since this association between STIs and peak HIV prevalence applies to a range of viral [ 28 , 29 ], bacterial [ 3 , 18 , 29 , 33 ], eukaryotic [ 34 ], and polymicrobial infections [ 35 ], it is less likely that it is due to biological increased susceptibility to each of these very different categories of microbes. Fourthly, the way that these large differences in STI prevalence are found within Kenya's ethnic groups—all of which are black African—suggests that racial differences in susceptibility do not play a major role.…”

Section: Discussionmentioning

confidence: 99%

“…For HSV-2, we could only find early prevalence data from one country—the USA in 1976−1980 and 1988–1994 [ 15 ]. There is evidence that HIV may increase the transmission of certain STIs such as HSV-2 [ 16 ] and, via a number of distinct mechanisms, decrease the transmission of others such as syphilis [ 17 , 18 ]. To avoid confounding by HIV prevalence, we used the earliest available representative STI prevalence data.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

The Prevalence of HIV by Ethnic Group Is Correlated with HSV-2 and Syphilis Prevalence in Kenya, South Africa, the United Kingdom, and the United States

Kenyon

Osbak

Buyze

2014

Interdisciplinary Perspectives on Infectious Diseases

Self Cite

View full text Add to dashboard Cite

Background. This paper investigates two issues: do ethnic/racial groups with high HIV prevalences also have higher prevalences of other STIs? and is HIV prevalence by ethnic group correlated with the prevalence of circumcision, concurrency, or having more than one partner in the preceding year? Methods. We used Spearman's correlation to estimate the association between the prevalence of HIV per ethnic/racial group and HSV-2, syphilis, symptoms of an STI, having more than one partner in the past year, concurrency, and circumcision in Kenya, South Africa, the United Kingdom, and the United States. Results. We found that in each country HSV-2, syphilis, and symptomatic STIs were positively correlated with HIV prevalence (HSV-2: Kenya rho = 0.50, P = 0.207; South Africa rho-1, P = 0.000; USA rho-1, P = 0.000, Syphilis: Kenya rho = 0.33, P = 0.420; South Africa rho-1, P = 0.000; USA rho-1, P = 0.000, and STI symptoms: Kenya rho = 0.92, P = 0.001; South Africa rho-1, P = 0.000; UK rho = 0.87, P = 0.058; USA rho-1, P = 0.000). The prevalence of circumcision was only negatively associated with HIV prevalence in Kenya. Both having more than one partner in the previous year and concurrency were positively associated with HIV prevalence in all countries (concurrency: Kenya rho = 0.79, P = 0.036; South Africa rho-1, P = 0.000; UK 0.87, P = 0.058; USA rho-1, P = 0.000 and multiple partners: Kenya rho = 0.82, P = 0.023; South Africa rho-1, P = 0.000; UK rho = 0.87, P = 0.058; USA rho-1, P = 0.000). Not all associations were statistically significant. Conclusion. Further attention needs to be directed to what determines higher rates of partner change and concurrency in communities with high STI prevalence.

show abstract

Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The Prevalence of HIV by Ethnic Group Is Correlated with HSV-2 and Syphilis Prevalence in Kenya, South Africa, the United Kingdom, and the United States

Kenyon

Osbak

Buyze

2014

Interdisciplinary Perspectives on Infectious Diseases

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this paper we assess if the prevalence of syphilis is correlated with HSV-2 prevalence at a country level in two time periods: 1990–99 and 2008. We include two time periods as there was a dramatic decline in syphilis prevalence at the end of the 20th century in the previously hyperendemic countries in sub-Saharan Africa [ 9 , 10 ]. This decline was likely due to a combination of factors but one of these was the effect of AIDS mortality on the structure of sexual networks [ 9 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…We include two time periods as there was a dramatic decline in syphilis prevalence at the end of the 20th century in the previously hyperendemic countries in sub-Saharan Africa [ 9 , 10 ]. This decline was likely due to a combination of factors but one of these was the effect of AIDS mortality on the structure of sexual networks [ 9 , 11 , 12 ]. If AIDS mortality disrupted sexual network connectivity sufficiently to reduce syphilis prevalence then this could diminish or eliminate a relationship between HSV-2 and syphilis prevalence.…”

Section: Introductionmentioning

confidence: 99%

Strong Country Level Correlation between Syphilis and HSV-2 Prevalence

Kenyon

Tsoumanis

Osbak

2016

Journal of Sexually Transmitted Diseases

Self Cite

View full text Add to dashboard Cite

Background. Syphilis is curable but Herpes Simplex Virus-2 (HSV-2) is not. As a result, the prevalence of syphilis but not HSV-2 may be influenced by the efficacy of national STI screening and treatment capacity. If the prevalence of syphilis and HSV-2 is found to be correlated, then this makes it more likely that something other than differential STI treatment is responsible for variations in the prevalence of both HSV-2 and syphilis. Methods. Simple linear regression was used to evaluate the relationship between national antenatal syphilis prevalence and HSV-2 prevalence in women in two time periods: 1990–1999 and 2008. Adjustments were performed for the laboratory syphilis testing algorithm used and the prevalence of circumcision. Results. The prevalence of syphilis was positively correlated with that of HSV-2 for both time periods (adjusted correlations, 20–24-year-olds: 1990–99: R 2 = 0.54, P < 0.001; 2008: R 2 = 0.41, P < 0.001 and 40–44-year-olds: 1990–99: R 2 = 0.42, P < 0.001; 2008: R 2 = 0.49, P < 0.001). Conclusion. The prevalence of syphilis and HSV-2 is positively correlated. This could be due to a common set of risk factors underpinning both STIs.

show abstract

The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management

2021

View full text Add to dashboard Cite

Purpose of Review To highlight recent trends in the epidemiology of HIV and syphilis, the impact of the COVID epidemic, our approach to care of co-infected patients, and our views on important next steps in advancing the field. Recent Findings HIV and syphilis co-infection has been on the rise in recent years although since the COVID pandemic there is a decrease in new diagnoses—it remains unclear if this represents a true decline or inadequate testing or under-reporting. Standard HIV care should include regular syphilis serology .Treatment and serological follow-up of syphilis in HIV positive and negative patients can be conducted similarly. Challenges remain in the diagnosis and management of neurosyphilis. New models for testing and prevention will be crucial next steps in controlling co-infection. Summary The intersection of HIV and syphilis infections continues to pose new and unique challenges in diagnosis, treatment, and prevention.

show abstract

What underpins the decline in syphilis in Southern and Eastern Africa? An exploratory ecological analysis

Cited by 23 publications

References 37 publications

The Prevalence of HIV by Ethnic Group Is Correlated with HSV-2 and Syphilis Prevalence in Kenya, South Africa, the United Kingdom, and the United States

The Prevalence of HIV by Ethnic Group Is Correlated with HSV-2 and Syphilis Prevalence in Kenya, South Africa, the United Kingdom, and the United States

Strong Country Level Correlation between Syphilis and HSV-2 Prevalence

The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management

Contact Info

Product

Resources

About