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P728 Correlates of syphilis in women living with and without HIV in the US women’s interagency HIV study (WIHS)
  1. Kristal Aaron1,
  2. Ilene Brill2,
  3. Zenoria Causey1,
  4. Kerry Murphy3,
  5. Michael Augenbraun4,
  6. Seble Kassaye5,
  7. Joel Milam6,
  8. Dominika Seidman7,
  9. Audrey French8,
  10. Stephen Gange9,
  11. Adaora Adimora10,
  12. Anandi Sheth11,
  13. Margaret Fischl12,
  14. Mirjam-Colette Kempf13,
  15. Jeanne Marrazzo1,
  16. Barbara Van Der Pol1,
  17. Jodie Dionne-Odom1
  1. 1University of Alabama at Birmingham, Medicine/Infectious Diseases, Birmingham, USA
  2. 2University of Alabama at Birmingham, School of Public Health/Biostatistics, Birmingham, USA
  3. 3Albert Einstein College of Medicine, Medicine/Infectious Diseases, Bronx, USA
  4. 4SUNY Downstate College of Medicine, Medicine/Infectious Diseases, Brooklyn, USA
  5. 5Georgetown University, Medicine/Infectious Diseases, Washington, USA
  6. 6University of Southern California, Medicine/Research Preventive Medicine, Los Angeles, USA
  7. 7University of California San Francisco, Medicine/Ob/Gyn, Reproductive Sciences, San Francisco, USA
  8. 8Cook County Health System, Medicine/Infectious Diseases, Chicago, USA
  9. 9Johns Hopkins University, Bloomberg School of Public Health/Epidemiology, Baltimore, USA
  10. 10University of North Carolina, Medicine/Infectious Diseases, Chapel Hill, USA
  11. 11Emory University, Medicine/Infectious Diseases, Atlanta, USA
  12. 12University of Miami, Medicine/Infectious Diseases, Miami, USA
  13. 13University of Alabama at Birmingham, Nursing Family, Comm and Health Systems, Birmingham, USA


Background Population-based estimates of syphilis seroprevalence and risk factors for US women are lacking. The objective of this study was to examine the prevalence of syphilis and associated characteristics among women living with and without HIV in the Women’s Interagency HIV Study (WIHS).

Methods Women enrolled in the multisite US WIHS Cohort Study between 1995 and 2016 were screened for syphilis at baseline using rapid plasma reagin (RPR) and confirmatory treponemal antibody testing. Prevalent syphilis was defined by a positive RPR and positive confirmatory test. Baseline characteristics among seropositive participants were compared with and without stratification by HIV status. Chi-square testing was used for comparisons for categorical variables while ANOVA or the Kruskal-Wallis test was used to test continuous variables. Multivariable logistic regression modeling with Firth’s bias correction for prediction of syphilis seroprevalence was performed using baseline covariates from the non-stratified characteristics that were statistically significant at p<0.05.

Results Nearly 5,000 women (n=4,906) age 16–57 were included in the analysis: 3,622 women with HIV and 1,284 women without HIV. The prevalence of syphilis in women with HIV (7.6%) was higher compared to women without HIV (4.6%), p<0.001. Characteristics associated with syphilis infection at the baseline cohort visit (p<0.05) included positive HIV status [adjusted odds ratios and 95% confidence intervals, OR, (95%CI)], [1.49 (1.09–2.04)], black race compared to white, [3.32 (2.06–5.36)], <12th grade education [1.72 (1.24–2.38)], income <$12,000 [1.46 (1.08–1.97)], and history of transactional sex [2.61 (1.98–3.43)].

Conclusion In the midst of a resurgence of syphilis infections in the US, factors associated with syphilis in women can help guide screening practice in clinic. This data from the WIHS cohort highlights the need for providers to consider HIV status, race, transactional sex and socioeconomics in order to identify women in need of routine syphilis screening.

Disclosure No significant relationships.

  • syphilis
  • HIV
  • risk factors

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