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Objectives The present study investigates the varied spatial distribution of syphilis cases in Shenzhen, China, and explores the individual-, neighbourhood- and district-level factors affecting the distribution. Methods This study uses spatial analysis and multi-level generalised estimating equations to explore the spatial distribution of reported syphilis cases among individuals in Shenzhen, Guangdong Province, China. The spatial distribution of primary/secondary and latent cases was investigated using the Moran's I-statistic. Primary/ secondary syphilis cases were compared with all syphilis cases using a three-level model with individual (n=6496), neighbourhood (n=55) and district (n=6) levels. Results A total of 6496 syphilis cases were reported in 2009 with 35.8% primary and secondary syphilis cases. Both primary/secondary syphilis cases (Moran's I value=0.33, p<0.01) and latent syphilis cases (Moran's I value=0.19, p<0.01) showed significant spatial clustering at the neighbourhood level. Adjusting for the number of reporting hospitals, the best model found that the following characteristics were associated with primary/secondary syphilis infection: individuals who are younger in age (p=0.003), male (p<0.001), migrant labourers (p=0.047) and those who live in districts with a higher gross domestic product (p<0.001). Conclusions There is substantial clustering of primary and secondary syphilis cases at the neighbourhood level in Shenzhen, suggesting the need for greater STD health service provision in these clustered neighbourhoods. Spatially targeted syphilis control measures may be useful to optimise testing, treatment and partner services. [ABSTRACT FROM AUTHOR]

Background Over three-quarters of new HIV infections in China during 2009 were estimated to be from sexual transmission. Over half of those living with HIV do not know their serostatus and identifying and treating individuals with sexually transmitted HIV infection has been challenging. Objective This global assessment explores Chinese systems for detecting and treating those with HIV infection with a particular focus on groups at increased risk of sexually transmitted HIV. Methods Published literature, grey sources and non-governmental reports were reviewed to describe HIV testing and care systems in China. Results HIV testing and care in China involve several parallel health systems and have been largely successful in reaching large numbers of vulnerable individuals. Provider-initiated testing and counselling has been more effective than voluntary counselling and testing programmes for expanding HIV testing efforts in China. Individuals with sexually transmitted HIV infection are underrepresented in the antiretroviral care system compared with other high-risk groups. Conclusions Comprehensive HIV testing and care bring together a number of Chinese health systems, but there are still gaps and challenges. Research and programmes focused on HIV testing and care for those with increased sexual risk are needed. [ABSTRACT FROM AUTHOR]

Background Ocular syphilis among HIV-infected patients continues to be a problem in the highly active antiretroviral therapy (HAART) era. However, outside of case reports or small case series, little is known about the clinical, laboratory, and treatment outcomes of these patients. Objective To examine the literature on HIV-infected patients and determine the results of treatment. Methods Systematic review of cases series and case reports among HIV-infected individuals with ocular syphilis. Reviews, languages other than English and pre-1980 reports were excluded. The effect of CD4 count and virological suppression on clinical manifestations and diagnostic laboratory values was evaluated. Results A total of 101 HIV-infected individuals in case series and case reports were identified. Ocular syphilis led to the HIV diagnosis in 52% of cases, including patients with CD4 count >200 cells/mm³. Posterior uveitis was significantly more common in individuals with CD4 count <200 cells/mm³ (p=0.002). Three patients with confirmed ocular syphilis had negative non-treponemal tests. Ninety-seven per cent of patients with visual impairment improved following intravenous penicillin or ceftriaxone. Conclusions Non-treponemal tests may be negative in HIV-infected patients with ocular syphilis. Ocular syphilis remains an important clinical manifestation that can lead to initial HIV diagnosis. [ABSTRACT FROM AUTHOR]

The article examines syphilis epidemiology, risk behaviours, control strategies and research priorities in China in the face of a rising syphilis epidemic there in 2011. The two high-risk groups are reportedly men who have sex with men (MSM) and low tier female sex workers (FSW), which are both difficult to track. The article states that control strategies in China include screening, diagnosis and treatment, partner notification and education campaigns, and that it will need further research.

The article elaborates the impact of the discovery of the antisyphilis drug, Salvarsan, in 1909 on veneral disease care in Great Britain through 1943, including the creation of venereology as a medical subspecialty and increased syphilis screening.

The authors discuss the results of a research published within issue about the possible implications of the 1909 discovery of the drug Salvarsan for treating syphilis, a venereal disease, for HIV cure preparedness. Topics discussed include a review of related literature on syphilis treatment, the significant lesson from the development of syphilis cures, and the key role of policy stakeholders in interpreting new cures into implementable programs.

The article presents public awareness campaign posters depicting development of syphilis cures in Great Britain from 1941 to 1945.

The article focuses on the discovery of the antisyphilis drug, Salvarsan, by German scientist Paul Ehrlich in 1909.

The article describes how the introduction of penicillin revolutionized venereology care in Great Britain from 1944 to 1964.

Objective China's sexually transmitted infection (STI) epidemic requires comprehensive control programmes. Partner services are traditional pillars of STI control but have not been widely implemented in China. This study was a systematic literature review to examine STI partner notification (PN) uptake in China. Methods Four English and four Chinese language databases were searched up to March 2011 to identify articles on PN of STIs including HIV in China. PN uptake was defined as the number of partners named, notified, evaluated or diagnosed per index patient. Results A total of 11 studies met inclusion criteria. For STI (excluding HIV) PN, a median 31.6% (IQR 27.4%--65.8%) of named partners were notified, 88.8% (IQR 88.4%--90.8%) of notified partners were evaluated and 37.9% (IQR 33.1%--43.6%) of evaluated partners were diagnosed. For HIV PN, a median 15.7% (IQR 13.2%--36.5%) of named partners were notified, 86.7% (IQR 72.9%--90.4%) of notified partners were evaluated and 27.6% (IQR 24.1%--27.7%) of evaluated partners were diagnosed. A mean of 80.6% (SD=12.6%) of patients attempted PN, and 72.4% (IQR 63.8%--81.1%) chose self-referral when offered more than one method of PN. Perceived patient barriers included social stigma, fear of relationship breakdown, uncertainty of how to notify and lack of partner contact information. Perceived infrastructure barriers included limited time and trained staff, mistrust of health workers and lack of PN guidelines. Conclusion PN programmes are feasible in China. Further research on STI PN, particularly among men who have sex with men and other high-risk groups, is an important public health priority. PN policies and guidelines are urgently needed in China. [ABSTRACT FROM AUTHOR]

The article details how the introduction of penicillin in 1943 as treatment for syphilis influenced venereology and sexual healthcare delivery systems in mid-20th century Great Britain. Topics discussed include the change in public perception that venereal disease is a public threat and deserves fewer resources for control, the drastic reduction in syphilis cases in the late 1940s and early 1950s, and the factors behind the rise in syphilis cases during the late 1950s and early 1960s.

The article recounts that the presentation by German scientist Paul Ehrlich in August 1913 of his antisyphilis drug, Salvarsan, has led the British Parliament to pass a resolution enacting the creation of Royal Commission on Venereal Diseases charged with directing veneral disease policy.

The authors discuss the role of general practitioners (GPs) in mainstreaming HIV services for men who have sex with men (MSM). They compare the health problems and health-seeking behaviours of MSM and other men seen by GPs. They mention the need for MSM to establish a long-term relationship with their chosen doctor. The authors also cite potential ways to develop a primary care HIV service model for MSM patients.

Objectives Low rates of HIV testing drive the rapidly growing HIV epidemic among men who have sex with men (MSM) in China. We examined the potential usefulness of couple-based and collective HIV testing strategies among Chinese MSM. Methods A cross-sectional online survey was conducted among 1113 MSM in 2013. Multivariable logistic regression analyses were conducted to identify factors associated with willingness to receive couple- based and collective testing. Results Acceptability of couple-based testing was very high among participants (86.1%), with a moderate level of interest in collective testing (43.2%). Being 'out' to others about one's sexual identity (adjusted OR (AOR)=1.48, 95% CI 1.01 to 2.17) and having ever had an HIV test (AOR=3.05, 95% CI 2.10 to 4.33) were associated with willingness to receive couple-based testing. Having multiple male anal sex partners in the past 3 months was associated with willingness to participate in collective testing (AOR=1.43, 95% CI 1.03 to 1.99). Discussion Couple-based and collective HIV testing could help better control the HIV epidemic among Chinese MSM if implemented and promoted in a culturally competent manner. [ABSTRACT FROM AUTHOR]

Objective: To measure prevalence of syphilis among the STI clinic population in Guangxi, China, and to assess the socioeconomic and behavioural characteristics associated with the infection. Methods: We undertook a cross-sectional survey and syphilis and HIV serologic testing among 11 473 patients attending 14 community and hospital-based dermatovenereal clinics across eight cities in Guangxi between December 2004 and February 2006. Results: 1297 (11.9%) patients demonstrated positive toludine red unheated serum test and Treponema pallidum particle agglutination results with serologic testing. A total of 58% (752) of seropositive subjects presented with a genital ulcer, palmar/plantar rash or inguinal lymphadenopathy. Female sex (OR = 2.23, 95% confidence intervals (CI)= 1.69 to 3.00, p<0.001), less education (middle school, OR= 1.70, 95% Cl = 1.11 to 2.62, p=0.023; primary school or less, OR= 1.98, 95% Cl = 1.13 to 3.46, p =0.017) and high annual income (OR = 1 .91, 95% CI = 1 .18 to 3.10, p = 0.009 for >30 000 RMB yuan) were associated with serologically positive status. Syphilis infection was significantly more prevalent in city 2 (19.5%, OR=3.07, 95% CI=1.83 to 5.16, p<0.001), city 4(16.6%, OR=1.90, 95% Cl=1.10 to 3.28, p=0.011) and city 8 (13.8%, OR= 1.83, 95% Cl = 1.13 to 2.97, p=0.006). A total of 40.1% (532) of infected subjects engaged in commercial sex and increased rates of the infection was associated with multiple sexual partners (OR = 1 .54, 95% CI = 1.16 to 2.06, p = 0.003). A total of 1 .2% (133) of participants carried laboratory markers for HIV and 1.8% (23) of patients with syphilis were positive for HIV. Conclusions: Syphilis infection has reached alarming rates in China's STI clinic population, suggesting a generalised spread of the disease through commercial sex and bridging populations. Syphilis control is deserving of China's highest priority. Universal screening for syphilis and HIV testing in STI clinics should be considered as measures for control. [ABSTRACT FROM AUTHOR]