Correlates of syphilis seroreactivity among pregnant women: the HIVNET 024 Trial in Malawi, Tanzania, and Zambia.
OBJECTIVE
The objectives of this cross-sectional study were to determine correlates of syphilis seroprevalence among HIV-infected and -uninfected antenatal attendees in an African multisite clinical trial, and to improve strategies for maternal syphilis prevention.


RESULTS
A total of 2,270 (86%) women were HIV-infected and 366 (14%) were HIV-uninfected. One hundred seventy-five (6.6%) were syphilis-seropositive (7.3% among HIV-infected and 2.6% HIV-uninfected women). Statistically significant correlates included geographic site (odds ratio [OR] = 4.5, Blantyre; OR = 3.2, Lilongwe; OR = 9.0, Lusaka vs. Dar es Salaam referent); HIV infection (OR = 3.3); age 20 to 24 years (OR = 2.5); being divorced, widowed, or separated (OR = 2.9); genital ulcer treatment in the last year (OR = 2.9); history of stillbirth (OR = 2.8, one stillbirth; OR = 4.3, 2-5 stillbirths); and history of preterm delivery (OR = 2.7, one preterm delivery).


CONCLUSIONS
Many women without identified risk factors were syphilis-seropositive. Younger HIV-infected women were at highest risk. Universal integrated antenatal HIV and syphilis screening and treatment is essential in sub-Saharan African settings.
Potter
Dara
D
School of Public Health, University of Alabama at Birmingham, USA.
Goldenberg
Robert L
RL
Read
Jennifer S
JS
Wang
Jing
J
Hoffman
Irving F
IF
Saathoff
Elmar
E
Kafulafula
George
G
Aboud
Said
S
Martinson
Francis E A
FE
Dahab
Maysoon
M
Vermund
Sten H
SH
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000367:Age Factors; D002986:Clinical Trials as Topic; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013587:Syphilis / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control; D013588:Syphilis Serodiagnosis