HIV prevalence in patients with syphilis, United States

Background: Among persons with a sexually transmitted disease (STD), the proportion who are also infected with HIV is a major factor influencing the public health impact of that STD on HIV transmission. Goal: To assess HIV infection in persons with syphilis in the United States. Study Design: A systematic literature review was conducted of U.S. studies with HIV seroprevalence data in patients with syphilis, Results: Thirty studies were identified and analyzed. The median HIV seroprevalence in men and women infected with syphilis was 15.7% (interquartile range [IQR]: 13.6-21.8%), among men was 27.5% (23.1-29.6%), and among women was 12.4% (8.3-20.5%). Median odds ratios for men and women, men only, and women only were 4.5, 8.5, and 3.3, respectively. Seroprevalences among men who have sex with men (MSM) and injecting drug users (IDU) ranged from 64.3-90.0% and 22.5-70.6%, respectively. Conclusions: Despite substantial variability, HIV seroprevalence is high among patients with syphilis in the United States, identifying them as a critical target group for HIV prevention efforts.