Zeng Qingling, Yang Yuhui, Zhang Limin, Yan Jiangyu, Wang Jian, Nie Jingmin, Wang Qingmei, Luo Yu, Li Gaoming
Department of Cardiovascular, Xinqiao Hospital, Army Medical University, Chongqing, China.
School of Nursing, Army Medical University, Chongqing, China.
J Int AIDS Soc. 2025 Jan;28(1):e26408. doi: 10.1002/jia2.26408.
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.
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.
The overall prevalence of syphilis among PLHIV in China was 18.6% (95% CI 16.5-21.0). Regional differences (R = 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 (R = 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 (R = 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).
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.
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.
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服务相结合来遏制梅毒传播。在此，我们旨在评估中国艾滋病病毒感染者（PLHIV）中梅毒患病率的变化。
我们通过检索PubMed、Embase、Web of Science、中国生物医学文献数据库、中国知网、万方和维普数据库，从建库至2024年6月1日获取相关文章，进行了这项系统评价和荟萃分析。最终纳入75项研究。我们使用DerSimonian-Laird随机效应模型来估计PLHIV中梅毒的患病率及95%置信区间。
中国PLHIV中梅毒的总体患病率为18.6%（95%CI 16.5-21.0）。患病率存在地区差异（R=15.29%）：东部地区为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）。患病率从2010年前的22.8%（18.4-27.9）降至2010年及之后的17.0%（14.6-19.6）（R=5.82%）。在通过同性传播感染艾滋病病毒的PLHIV中，梅毒患病率为24.9%（21.3-28.9），从2010年及之后的33.8%（27.5-40.8）显著降至21.4%（18.3-24.9）（R=22.35%）。感染艾滋病病毒的男性梅毒患病率显著高于感染艾滋病病毒的女性（合并比值比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）。
PLHIV中梅毒患病率，尤其是同性传播感染的患病率有所下降。梅毒患病率与地区经济状况之间存在关联，东部沿海发达地区负担更重。此外，梅毒风险在不同性别间存在差异，感染艾滋病病毒的男性风险更高。
在控制PLHIV中的梅毒方面已取得初步成效，但要实现世界卫生组织2030年梅毒防治目标仍有很长的路要走。梅毒预防措施应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群中。
