The Prevalence of Syphilis from the Early HIV Period Is Correlated with Peak HIV Prevalence at a Country Level
BACKGROUND:
Could
we have predicted national peak HIV based on syphilis prevalence in the 1990s?
Earlier studies have shown positive correlations between various sexually
transmitted infections at different population levels. In this article, we test
the hypothesis that there was a residual variation in the national prevalence
rates of syphilis and that these rates could predict subsequent peak HIV
prevalence rates.
METHODS:
This
analysis uses linear regression to evaluate the country-level relationship
between antenatal syphilis prevalence (1990-1999) and peak HIV prevalence.
Antenatal syphilis data were taken from an Institute for Health Metrics and
Evaluation database on the prevalence of syphilis in low-risk populations. Peak
HIV prevalence was calculated based on data taken from the Global Health
Observatory Data Repository of the World Health Organization.
RESULTS:
A
moderately strong association is found for the 76 countries with data available
(R = 0.53, P < 0.001). The association was weakened but remained
significantly positive when we adjusted for the type of syphilis testing used.
CONCLUSIONS:
Syphilis
prevalence in the 1990s predicted approximately 53% of the variation in peak
HIV prevalence. Populations with generalized HIV epidemics had a higher
prevalence of syphilis in the pre-HIV period. This finding provides additional
rationale to carefully monitor sexual behavior, sexual networks, and sexually
transmitted infection incidence in these populations.
- 1From the *HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium; †London, United Kingdom; ‡Institute for Health Metrics and Evaluation, Seattle Children's Hospital, University of Washington, Seattle, WA; and §Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa.
- Sex Transm Dis. 2016 Apr;43(4):255-7. doi: 10.1097/OLQ.0000000000000422.
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