Abstract
Sixty-seven transvestite prostitutes from Latin America (49 from Brazil and 18 from Colombia) who attended an HIV unit located in the inner city of Rome between January 1991 and June 1992 were studied for syphilis markers by means of both theTreponema pallidum haemoagglutination test (TPHA) and a solid phase haemadsorption test for detection of specific IgM (SPHA-IgM) which are typically present in recent infections. All participants reported more than 500 sexual partners in the past year, and 67.1% of them more than 1500 partners (between 5 and 10 partners per working day). The overall prevalence of anti-HIV antibodies in this population was 65.7%. The prevalence of positive TPHA tests in the population studied was 73.1%, while that of positive SPHA-IgM tests was 10.4%. The prevalence of positive TPHA and SPHA-IgM tests was higher among Colombians than among Brazilians (83.3% vs 69.4% and 22.2% vs 6.1%, respectively) and also showed a positive correlation with the duration of their permanence in Italy. The TPHA and SPHA-IgM positivities were significantly higher among subjects older than 29 years. Positive TPHA was also significantly higher in subjects who reported a history of heroin and/or cocaine abuse while positive SPHA-IgM was higher in subjects who did not use condoms or reported irregular use of them than in subjects who regularly used condoms. No overall correlation was evident between TPHA positivity and anti-HIV positivity, while SPHA-IgM positivity was found to be higher among anti-HIV-negative subjects. The population studied, therefore, apparently represents a relevant source for syphilis (in addition to HIV) transmission, due to the high number of sexual partners and to the overall irregular use of condoms, and it is likely that similar populations can largely contribute the maintenance of syphilis in industrialized countries. Fluorescent anti-treponemal antibody-absorption (FTA-ABS) and rapid plasma reagin (RPR) tests were also performed on all serum samples. Results of FTA-ABS were fully consistent with those of TPHA, while a lower degree of concordance was observed between RPR and TPHA.
Similar content being viewed by others
References
Bradford L, Larsen SA. Serologic tests for syphilis. In: Lennette H, ed. Manual of clinical microbiology. Washington, DC: Am Soc for Microbiol 1985: 910–920.
Centra Operativo AIDS, Istituto Superiore di Sanità. Sorveglianza nazionale della malattie sessualmente trasmesse, Rapporti Nos. 1, 2, 3, 1991–1992.
Centers for Disease Control. CDC classification system for human T-lymphotrophic virus type III lymphadenopathy associated virus infection. MMWR 1986; 35: 334–339.
Centers for Disease Control. Revision of CDC surveillance case definition for acquired immunodeficiency virus syndrome. MMWR 1987; 36: 35–145.
Centers for Disease Control. Primary and secondary syphilis. United States, 1981–90. MMWR 1991; 40: 314.
Darrow WW, Echemberg DF, Jaffe HW, et al. Risk factors for human immunodeficiency virus (HIV) infections in homosexual men. Am J Public Health 1987; 77: 479–483.
Department of Health, Education, and Welfare. Manual test for syphilis. Publication No. 411. Washington DC: US Government Printing Office, 1969.
Greenblott RM, Lukehart SA, Plummer FA, et al. Genital ulcerations as a risk factor for HIV infection. AIDS 1991; 2: 47–50.
Jaffe HW, Choi K, Thomas PA, et al. National case-control study of Kaposi's sarcoma andPneumocystis carinii pneumonia in homosexual men, Part 1: Epidemiological results. Ann Intern Med 1983; 99: 145–151.
Johnson PDR, Graves SR, Stewart L, et al. Specific syphilis serological tests may become negative in HIV infection. AIDS 1991; 5: 419–423.
Hicks CB, Benson PM, Lupton GP, et al. Seronegative secondary syphilis in a patient infected with the human immunodeficiency virus (HIV) with Kaposi's sarcoma: A diagnostic dilemma. Ann Intern Med 1987; 107: 492–495.
Holmberg SD, Horsburg CR Jr, Ward JW, et al. Biologic factors in the sexual transmission of HIV. J Infect Dis 1989; 160: 116–125.
Luger AFH. Serological diagnosis of syphilis: Current methods. In: Young H, McMillian A, eds., Immunological diagnosis of sexually transmitted diseases. New York: Marcel Dekker, 1988: 249–274.
Merlin S, Andre J, Alacoque B, Paris-Hamelin A. Importance of specific IgM antibodies in 116 patients with various stage of syphilis. Genitourin Med 1985; 61: 82–87.
Muller F, Lindenschmidt EG. Demonstration of specific 19S (IgM) antibodies in untreated and treated syphilis: Comparative studies of the 19S (IgM)-FTA test and the solid phase haemadsorption assay. Br J Vener Dis 1982; 58: 12–17.
Muller F, Wollemann G. Analysis of specific immunoglobulin M immune response toTreponema pallidum before and after penicillin treatment of human syphilis. Eur J Sex Trans Dis 1985; 2: 67–72.
Rolfs RT, Nakashima AK. Epidemiology of primary and secondary syphilis in the United States, 1981–1989. JAMA 1990; 264: 1432–1437.
Schmidt BL. Solid phase hemadsorption: A method for rapid detection ofTreponema pallidum-specific IgM. Sex Transm Dis 1980; 7: 53–58.
Schmitz JL, Gertis KL, Mauney C, Stamm LV, Folds JD. Laboratory diagnosis of congenital syphilis by immunoglobulin m (IgM) and IgA immunoblotting. Clin Diagn Lab Immun 1994; 1: 32–37.
Stamm WE, Handsfield HH, Rompalo AM, et al. The association between genital ulcer disease and acquisition of HIV infection in homosexual men. JAMA 1988; 260: 1429–1433.
Young H. Syphilis: New diagnostic direction. Int J of STD and AIDS 1992; 3: 391–413.
Author information
Authors and Affiliations
Additional information
Revised paper presented in part as a poster at the 10th International Meeting of the International Society for STD Research, Helsinki, Finland, 29 August–1 September 1993.
Rights and permissions
About this article
Cite this article
Gattari, P., Speziale, D., Grillo, R. et al. Syphilis serology among transvestite prostitutes attending an HIV unit in Rome, Italy. Eur J Epidemiol 10, 683–686 (1994). https://doi.org/10.1007/BF01719281
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01719281