Prevalence and risk factors associated with HIV and syphilis co‑infection in the African Cohort Study: a cross‑sectional study

Simple item page
dc.contributor.authorGilbert, Laura
dc.contributor.authorDear, Nicole
dc.contributor.authorEsber, Allahna
dc.contributor.authorIroezindu, Michael
dc.contributor.authorBahemana, Emmanuel
dc.contributor.authorKibuuka, Hannah
dc.contributor.authorOwuoth, John
dc.contributor.authorMaswai, Jonah
dc.contributor.authorCrowell, Trevor A.
dc.contributor.authorPolyak, Christina S.
dc.contributor.authorAke, Julie A.
dc.date.accessioned2022-12-15T18:00:43Z
dc.date.available2022-12-15T18:00:43Z
dc.date.issued2021
dc.description.abstractEach year, 5.6 million new syphilis cases are diagnosed globally. Guidelines for people living with HIV (PLWH) in low-income countries (LIC) recommend STI testing for symptomatic persons and those newly diagnosed with HIV; routine STI testing is less clear. Here we provide updated syphilis prevalence and identify co-infection risk factors in PLWH in the African Cohort Study (AFRICOS) to understand these rates as they relate to syndromic treatment. Methods: AFRICOS is a study enrolling PLWH and HIV-uninfected individuals in four African countries. Participant study enrollment information was used to determine syphilis prevalence and co-infection risk factors. Inclusion criteria consisted of adults 18 years or older receiving care at a participating clinic as a long-term resident who consented to data and specimen collection. Exclusion criteria consisted of pregnancy and/or imprisonment. Screen-positive syphilis was defined as a reactive rapid plasma regain (RPR) upon study enrollment whereas confirmed syphilis included a reactive RPR followed by reactive treponemal test. Multivariate analyses was performed to determine HIV and syphilis co-infection risk factors. Results: Between 2013 and March 1, 2020, 2939 PLWH enrolled and 2818 were included for analysis. Screen-positive and confirmed syphilis prevalence were 5.3% (151/2818) and 3.1% (87/2818), respectively. When the analysis was restricted to PLWH with an RPR titer of greater than, or equal to, 1:8, 11/87 (12.6%) participants were included. No PLWH and confirmed syphilis had documented genital ulcers. In the multivariate model, participants with confirmed syphilis co-infection were more likely to have none or some primary education [aOR 3.29 (1.60, 6.74)] and consume alcohol [aOR 1.87 (1.16, 3.03)] compared to those without syphilis. Antiretroviral therapy (ART) with suppressed viral load (VL) was protective in the unadjusted model but not adjusted multivariate model. Conclusions: Our findings show that syphilis rates in sub-Saharan Africa remain elevated where diagnosis remains challenging, and that both lower education level and alcohol consumption are significantly associated with HIV/syphilis co-infection in AFRICOS. Based on our analysis, current STI guidelines targeting testing for African individuals with either new HIV diagnosis or syndromic symptoms may be inadequate, highlighting the need for increased testing and treatment strategies in resource-limited settings.en_US
dc.identifier.citationGilbert, L., Dear, N., Esber, A., Iroezindu, M., Bahemana, E., Kibuuka, H., ... & Ake, J. A. (2021). Prevalence and risk factors associated with HIV and syphilis co-infection in the African Cohort Study: a cross-sectional study. BMC Infectious Diseases, 21(1), 1-7. https://doi.org/10.1186/s12879-021-06668-6en_US
dc.identifier.urihttps://doi.org/10.1186/s12879-021-06668-6
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/6335
dc.language.isoenen_US
dc.publisherBMC Infectious Diseasesen_US
dc.subjectHuman immunodeficiency virus (HIV)en_US
dc.subjectSyphilisen_US
dc.subjectAfricaen_US
dc.titlePrevalence and risk factors associated with HIV and syphilis co‑infection in the African Cohort Study: a cross‑sectional studyen_US
dc.typeArticleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Prevalence and risk factors associated.pdf
Size:
917.89 KB
Format:
Adobe Portable Document Format
Description:
Article
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Medical and Health Sciences