Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods

David Siegel, Sandra A. Larsen, Eve Golden, Stephen Morse, Mindy T. Fullilove, A. Eugene Washington

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

To examine the extent of infection with syphilis in an inner-city community, we determined the prevalence, incidence, and correlates of syphilis seroreactivity in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. One thousand seven hundred seventy single men and women aged 20 to 44 were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Syphilitic infection was determined by testing specimens with the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). Of blood samples available from 1262 participants from the initial survey, 32 (2.5%) were MHA-TP reactive. After adjustment for age, a reactive syphilis serology was significantly predicted (P < 0.05) by African American race, homosexual activity (men), and less education. In homosexually active men, lifetime number of male sex partners and the presence of antibody to the human immunodeficiency virus (HIV) significantly predicted syphilis seroreactivity (P < 0.01). One year later, of 841 specimens available for testing, an additional 13 (1.5%) had become MHA-TP reactive. Eleven (85%) of the new cases were in heterosexual men and women. Although San Francisco citywide incidence data indicate that syphilis may be decreasing for the city as a whole, incidence data on a community level suggests that syphilitic infection is increasing in high-risk heterosexual communities. Thus, syphilis prevention programs should rely on serologic testing at the community level to plant effective intervention strategies.

Original languageEnglish (US)
Pages (from-to)460-465
Number of pages6
JournalAnnals of Epidemiology
Volume4
Issue number6
DOIs
StatePublished - 1994
Externally publishedYes

Fingerprint

San Francisco
Syphilis
Incidence
Heterosexuality
African Americans
Infection
Cultural Characteristics
Treponema pallidum
Antibodies
Serology
Hispanic Americans
HIV
Education

Keywords

  • Human immunodeficiency virus
  • microhemagglutination assay for antibodies to Treponema pallidum
  • sexually transmitted disease
  • syphilis

ASJC Scopus subject areas

  • Medicine(all)
  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods. / Siegel, David; Larsen, Sandra A.; Golden, Eve; Morse, Stephen; Fullilove, Mindy T.; Washington, A. Eugene.

In: Annals of Epidemiology, Vol. 4, No. 6, 1994, p. 460-465.

Research output: Contribution to journalArticle

Siegel, David ; Larsen, Sandra A. ; Golden, Eve ; Morse, Stephen ; Fullilove, Mindy T. ; Washington, A. Eugene. / Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods. In: Annals of Epidemiology. 1994 ; Vol. 4, No. 6. pp. 460-465.
@article{dd50e4633680473aaf9a8af9448c1378,
title = "Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods",
abstract = "To examine the extent of infection with syphilis in an inner-city community, we determined the prevalence, incidence, and correlates of syphilis seroreactivity in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. One thousand seven hundred seventy single men and women aged 20 to 44 were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Syphilitic infection was determined by testing specimens with the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). Of blood samples available from 1262 participants from the initial survey, 32 (2.5{\%}) were MHA-TP reactive. After adjustment for age, a reactive syphilis serology was significantly predicted (P < 0.05) by African American race, homosexual activity (men), and less education. In homosexually active men, lifetime number of male sex partners and the presence of antibody to the human immunodeficiency virus (HIV) significantly predicted syphilis seroreactivity (P < 0.01). One year later, of 841 specimens available for testing, an additional 13 (1.5{\%}) had become MHA-TP reactive. Eleven (85{\%}) of the new cases were in heterosexual men and women. Although San Francisco citywide incidence data indicate that syphilis may be decreasing for the city as a whole, incidence data on a community level suggests that syphilitic infection is increasing in high-risk heterosexual communities. Thus, syphilis prevention programs should rely on serologic testing at the community level to plant effective intervention strategies.",
keywords = "Human immunodeficiency virus, microhemagglutination assay for antibodies to Treponema pallidum, sexually transmitted disease, syphilis",
author = "David Siegel and Larsen, {Sandra A.} and Eve Golden and Stephen Morse and Fullilove, {Mindy T.} and Washington, {A. Eugene}",
year = "1994",
doi = "10.1016/1047-2797(94)90006-X",
language = "English (US)",
volume = "4",
pages = "460--465",
journal = "Annals of Epidemiology",
issn = "1047-2797",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Prevalence, incidence, and correlates of syphilis seroreactivity in multiethnic San Francisco neighborhoods

AU - Siegel, David

AU - Larsen, Sandra A.

AU - Golden, Eve

AU - Morse, Stephen

AU - Fullilove, Mindy T.

AU - Washington, A. Eugene

PY - 1994

Y1 - 1994

N2 - To examine the extent of infection with syphilis in an inner-city community, we determined the prevalence, incidence, and correlates of syphilis seroreactivity in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. One thousand seven hundred seventy single men and women aged 20 to 44 were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Syphilitic infection was determined by testing specimens with the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). Of blood samples available from 1262 participants from the initial survey, 32 (2.5%) were MHA-TP reactive. After adjustment for age, a reactive syphilis serology was significantly predicted (P < 0.05) by African American race, homosexual activity (men), and less education. In homosexually active men, lifetime number of male sex partners and the presence of antibody to the human immunodeficiency virus (HIV) significantly predicted syphilis seroreactivity (P < 0.01). One year later, of 841 specimens available for testing, an additional 13 (1.5%) had become MHA-TP reactive. Eleven (85%) of the new cases were in heterosexual men and women. Although San Francisco citywide incidence data indicate that syphilis may be decreasing for the city as a whole, incidence data on a community level suggests that syphilitic infection is increasing in high-risk heterosexual communities. Thus, syphilis prevention programs should rely on serologic testing at the community level to plant effective intervention strategies.

AB - To examine the extent of infection with syphilis in an inner-city community, we determined the prevalence, incidence, and correlates of syphilis seroreactivity in a representative sample of unmarried whites, African Americans, and Hispanics living in San Francisco during 1988 to 1989 and again 1 year later in 1989 to 1990. One thousand seven hundred seventy single men and women aged 20 to 44 were surveyed in a random household sample drawn from three neighborhoods of varying geographic and cultural characteristics. Syphilitic infection was determined by testing specimens with the microhemagglutination assay for antibodies to Treponema pallidum (MHA-TP). Of blood samples available from 1262 participants from the initial survey, 32 (2.5%) were MHA-TP reactive. After adjustment for age, a reactive syphilis serology was significantly predicted (P < 0.05) by African American race, homosexual activity (men), and less education. In homosexually active men, lifetime number of male sex partners and the presence of antibody to the human immunodeficiency virus (HIV) significantly predicted syphilis seroreactivity (P < 0.01). One year later, of 841 specimens available for testing, an additional 13 (1.5%) had become MHA-TP reactive. Eleven (85%) of the new cases were in heterosexual men and women. Although San Francisco citywide incidence data indicate that syphilis may be decreasing for the city as a whole, incidence data on a community level suggests that syphilitic infection is increasing in high-risk heterosexual communities. Thus, syphilis prevention programs should rely on serologic testing at the community level to plant effective intervention strategies.

KW - Human immunodeficiency virus

KW - microhemagglutination assay for antibodies to Treponema pallidum

KW - sexually transmitted disease

KW - syphilis

UR - http://www.scopus.com/inward/record.url?scp=0028028298&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028028298&partnerID=8YFLogxK

U2 - 10.1016/1047-2797(94)90006-X

DO - 10.1016/1047-2797(94)90006-X

M3 - Article

VL - 4

SP - 460

EP - 465

JO - Annals of Epidemiology

JF - Annals of Epidemiology

SN - 1047-2797

IS - 6

ER -