Objective: To measure prevalence of syphilis among the STI clinic population in Guangxi, China, and to assess the socio-economic and behavioral characteristics associated with the infection.
Methods: We undertook a cross-sectional survey and syphilis and HIV serologic testing among 11,473 patients attending 14 community and hospital-based dermatovenereal clinics across eight cities in Guangxi between December 2004 and February 2006.
Results: 1,297 (11.9%) patients demonstrated positive TRUST and TPPA results with serologic testing. 58% (752) of sero-positive subjects presented with a genital ulcer, palmar/plantar rash or inguinal lymphadenopathy. Female sex (OR = 2.23, 95% confidence intervals (CI) = 1.69-3.00, p<0.001), less education (middle school, OR = 1.70, 95% CI = 1.11-2.62, p=0.023; primary school or less, OR = 1.98, 95% CI = 1.13-3.46, p=0.017) and high monthly income (OR = 1.91, 95% CI = 1.18-3.10, p=0.009 for > 30,000 RMB yuan) were associated with serologically positive status. Syphilis infection was significantly more prevalent in City 2 (19.5%, OR = 3.07, 95% CI = 1.83-5.16, p<0.001), City 4 (16.6%, OR = 1.90, 95% CI = 1.10-3.28, p=0.011) and City 8 (13.8%, OR = 1.83, 95% CI = 1.13-2.97, p=0.006). 40.1% (532) of infected subjects engaged in commercial sex and increased rates of infection was associated with multiple sexual partners (OR = 1.54, 95% CI = 1.16-2.06, p=0.003). 1.2% (133) of participants carried laboratory markers for HIV and 1.8% (23) of patients with syphilis were positive for HIV.
Conclusions: Syphilis infection has reached alarming rates in China's STI clinic population, suggesting a generalized spread of the disease through commercial sex and bridging populations. Syphilis control is deserving of China's highest priority. Universal screening for syphilis and HIV testing in STI clinics should be considered as measures for control.
- Commercial Sex
- STI Clinic