The impact of the National Syphilis Prevention Program on the prevalence of syphilis among people living with HIV in China: a systematic review and meta-analysis

IF 4.6 1区医学 Q2 IMMUNOLOGY

Journal of the International AIDS Society Pub Date : 2025-01-06 DOI:10.1002/jia2.26408

Qingling Zeng, Yuhui Yang, Limin Zhang, Jiangyu Yan, Jian Wang, Jingmin Nie, Qingmei Wang, Yu Luo, Gaoming Li

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Abstract

Introduction

In 2010, China launched the 10-year National Syphilis Prevention and Control Program to curb the spread of syphilis by integrating syphilis screening and treatment with HIV services. Herein, we aimed to evaluate changes in the prevalence of syphilis among people living with HIV (PLHIV) in China.

Methods

We conducted this systematic review and meta-analysis by searching the PubMed, Embase, Web of Science, China Biomedical Literature, China National Knowledge Infrastructure, Wanfang and CQVIP databases from inception to 1 June 2024 to obtain relevant articles. A total of 75 studies were ultimately included. We used a DerSimonian‒Laird random effects model to estimate the prevalence and 95% confidence interval of syphilis among PLHIV.

Results

The overall prevalence of syphilis among PLHIV in China was 18.6% (95% CI 16.5–21.0). Regional differences (R² = 15.29%) were observed in the prevalence rates: 22.2% (18.9–25.8) in the eastern region, 19.0% (15.1–23.8) in the central region and 14.0% (11.1–17.5) in the western region. The prevalence decreased from 22.8% (18.4–27.9) before 2010 to 17.0% (14.6–19.6) in 2010 and thereafter (R² = 5.82%). Among PLHIV via homosexual transmission, the prevalence of syphilis was 24.9% (21.3–28.9), which significantly declined from 33.8% (27.5–40.8) to 21.4% (18.3–24.9) in 2010 and thereafter (R² = 22.35%). The prevalence of syphilis was significantly higher in men living with HIV than in women living with HIV (pooled odds ratio 1.67, 95% CI 1.29–2.15), with the highest prevalence in the eastern region (2.55, 95% CI 1.80–3.59).

Discussion

The prevalence of syphilis among PLHIV, particularly in cases of homosexual transmission, has declined. There was a correlation between the prevalence of syphilis and regional economic conditions, with a greater burden in developed eastern coastal areas. Additionally, the risk of syphilis differed across sexes, with men living with HIV having a higher risk.

Conclusions

There has been preliminary success in the control of syphilis among PLHIV, but there is still a long way to go to meet the WHO's 2030 syphilis prevention and control goal. Syphilis prevention measures should be integrated into broader health policies and development plans, particularly in high-burden regions and populations.

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国家梅毒预防规划对中国HIV感染者梅毒患病率的影响：系统回顾和荟萃分析

2010年，中国启动了为期10年的全国梅毒防治规划，通过将梅毒筛查和治疗与艾滋病毒服务相结合，遏制梅毒的传播。在此，我们旨在评估中国HIV感染者（PLHIV）中梅毒患病率的变化。方法：检索PubMed、Embase、Web of Science、中国生物医学文献、中国知识基础设施、万方数据库和CQVIP数据库，从建库至2024年6月1日，进行系统评价和meta分析，获取相关文章。最终总共纳入了75项研究。我们使用dersimonan - laird随机效应模型来估计PLHIV中梅毒的患病率和95%置信区间。结果：中国hiv感染者中梅毒的总患病率为18.6% （95% CI 16.5-21.0）。东部地区患病率为22.2%(18.9 ~ 25.8)，中部地区为19.0%(15.1 ~ 23.8)，西部地区为14.0%(11.1 ~ 17.5)，区域差异R2 = 15.29%。患病率由2010年前的22.8%（18.4 ~ 27.9）下降至2010年后的17.0% (14.6 ~ 19.6)（R2 = 5.82%）。在经同性恋传播的hiv中，梅毒患病率为24.9%(21.3 ~ 28.9)，从2010年的33.8%（27.5 ~ 40.8）显著下降到2010年的21.4% (18.3 ~ 24.9)（R2 = 22.35%）。男性艾滋病毒感染者的梅毒患病率明显高于女性艾滋病毒感染者（合并优势比1.67,95% CI 1.29-2.15），东部地区患病率最高（2.55,95% CI 1.80-3.59）。讨论：梅毒在艾滋病毒感染者中的流行率，特别是在同性恋传播的情况下，已经下降。梅毒患病率与地区经济状况有相关性，东部沿海发达地区负担更重。此外，患梅毒的风险在性别上也存在差异，携带艾滋病毒的男性患梅毒的风险更高。结论：艾滋病病毒感染者中梅毒控制取得初步成功，但要实现世界卫生组织提出的2030年梅毒防控目标还有很长的路要走。应将预防梅毒措施纳入更广泛的卫生政策和发展计划，特别是在高负担地区和人口中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

8.60

自引率

10.00%

发文量

186

审稿时长

>12 weeks

期刊介绍： The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.