title: A prospective study of syphilis and HIV infection among injection drug users receiving methadone in the Bronx, NY.
abstract: OBJECTIVE
  The purpose of this study was to assess the relationship between syphilis and human immunodeficiency virus (HIV) infection in injection drug users.
  
  
  METHODS
  A 6-year prospective study of 790 injection drug users receiving methadone maintenance treatment in the Bronx, NY, was conducted.
  
  
  RESULTS
  Sixteen percent (4/25) of HIV-seroconverting patients, 4.8% (16/335) of prevalent HIV-seropositive patients, and 3.5% (15/430) of persistently HIV-seronegative patients was diagnosed with syphilis. Incidence rates for early syphilis (cases per 1000 person-years) were 15.9 for HIV-seroconverting patients, 8.9 for prevalent HIV-seropositive patients, and 2.9 for persistently HIV-seronegative patients. Early syphilis incidence was higher among women than men (8.4 vs 3.2 cases per 1000 person-years). Independent risks for early syphilis included multiple sex partners, HIV seroconversion, paid sex, and young age. All HIV seroconverters with syphilis were female.
  
  
  CONCLUSIONS
  Diagnosis of syphilis in drug-using women reflects high-risk sexual activity and is associated with acquiring HIV infection. Interventions to reduce the risk of sexually acquired infections are urgently needed among female drug users.
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Social Medicine, Montefiore Medical Center, Bronx, NY 10467, USA.
authors.forename: M N
authors.initials: MN
authors.lastname: Gourevitch
authors.forename: D
authors.initials: D
authors.lastname: Hartel
authors.forename: E E
authors.initials: EE
authors.lastname: Schoenbaum
authors.forename: P A
authors.initials: PA
authors.lastname: Selwyn
authors.forename: K
authors.initials: K
authors.lastname: Davenny
authors.forename: G H
authors.initials: GH
authors.lastname: Friedland
authors.forename: R S
authors.initials: RS
authors.lastname: Klein
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009519:New York City; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000188:drug therapy; D013587:Syphilis / Q000209:etiology*; D014504:Urban Health
chemical_list: D009294:Narcotics; D008691:Methadone