Levine WC, McKinley TW, Smith JD, Chapman KA, Elsea WR, Feldman L, Holloway JT, Wiesner PJ, McCurdy HH; International Conference on AIDS.
Int Conf AIDS. 1991 Jun 16-21; 7: 81 (abstract no. TH.C.100).
Division of Field Epidemiology, CDC, Atlanta, GA
OBJECTIVE: To assess the extent of recent drug use and HIV infection among patients with syphilis in urban and rural Georgia and to examine associations of syphilis stage with HIV seropositivity, we performed drug screening and HIV antibody testing on patients diagnosed with primary and secondary (P&S) syphilis who attended health department sexually transmitted disease clinics from March 1989 to February 1990. METHODS: Patients seen at clinics in 5 Georgia health districts, 2 urban and 3 rural, diagnosed with P&S syphilis, had a routine blood sample drawn for syphilis serology. These specimens were anonymously tested for cocaine, opiates, and antibodies to HIV. The patient's age, race, sex, sexual orientation, and syphilis stage were recorded using a standard form. RESULTS: Of 1343 patients tested, 164 (12.2%) were seropositive for HIV, with seroprevalence ranging from 2.6% in a rural district to 14.2% in an urban district. Cocaine was detected in sera of 7.3% of patients, indicating use in the previous 24 hours, and opiates in 0.4%. No significant associations were found between cocaine or opiates detected in sera and HIV seropositivity. Secondary syphilis was diagnosed in 362 (43.3%) of 836 males and 357 (73.9%) of 483 females, among patients for whom a diagnosis of primary or secondary syphilis had been recorded. Of 720 patients with secondary syphilis, 114 (15.8%) were HIV+, compared with only 49 (8.1%) of 602 with primary syphilis (p less than 0.001), with similar trends for men and women. Twenty (50.0%) of 40 male patients with secondary syphilis and a rapid plasma reagin reciprocal titer of greater than or equal to 512 were seropositive for HIV. DISCUSSION AND CONCLUSIONS: These data show that patients with syphilis are an important reservoir of HIV in urban and rural Georgia and that many present for treatment only after they have developed secondary syphilis. The role of cocaine in HIV transmission in this population and the reasons for higher HIV seroprevalence among patients with secondary syphilis remain to be clarified.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Ambulatory Care Facilities
- Chancre
- Female
- Georgia
- Georgia (Republic)
- HIV
- HIV Antibodies
- HIV Infections
- HIV Seropositivity
- HIV Seroprevalence
- Humans
- Male
- Mass Screening
- Reagins
- Seroepidemiologic Studies
- Sexual Behavior
- Substance-Related Disorders
- Syphilis
- Syphilis Serodiagnosis
Other ID:
UI: 102196853
From Meeting Abstracts