- Syphilis infection nears 1% in HIV-infected women.
- History of intravenous (IV) drug use and HCV infection are the best predictors of incident infection.
Why this matters
- Heightened risk suggests all pregnant women abusing drugs should be screened for syphilis.
- Retrospective study of the US Center for Aids Research Clinical Network of Integrated Clinical Systems Cohort, including 4795 women (27,249 woman-years).
- Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development.
- Median age; 47 years; 63% of women were black and 75% had acquired HIV infection through heterosexual sex.
- There were 760 cases of syphilis per 100,000 woman-years compared with 2.6 cases per 100,000 woman-years in the general population.
- After adjustment, factors associated with syphilis risk included prior IV drug abuse (aOR, 2.3; 95% CI, 1.3-3.9), presence of HCV antibodies (aOR, 2.1; 95% CI, 1.3-3.7), later year of entry to care (aOR, 2.3; 95% CI, 1.4-3.9 for 2011-2016 vs 1994-2004), and black race (aOR, 2.3; 95% CI, 1.4-3.9 vs white).
- The authors believe that the increased risk is likely a result of a high frequency of transactional sex.
- Retrospective analysis.
- "Finding the risk factors for these women and making sure that we're doing testing and treatment to catch people early is quite important." Susan Buchbinder, University of California, San Francisco.