A PROSPECTIVE-STUDY OF SYPHILIS AND HIV-INFECTION AMONG INJECTION-DRUG USERS RECEIVING METHADONE IN THE BRONX, NY

Objectives. The purpose of this study was to assess the relationship b etween syphilis and human immuno-deficiency virus (HIV) infection in i njection drug users. Methods. A 6-year prospective study of 790 inject ion drug users receiving methadone maintenance treatment in the Bronx, NY, was conducted. Results. Sixteen percent (4/25) of HIV-seroconvert ing patients, 4.8% (16/335) of prevalent HIV-seropositive patients, an d 3.5% (15/430) of persistently HIV-seronegative patients were diagnos ed with syphilis. Incidence rates for early syphilis (cases per 1000 p erson-years) were 15.9 for HIV-seroconverting patients, 8.9 for preval ent HIV-seropositive patients, and 2.9 for persistently HIV-seronegati ve patients, Early syphilis incidence was higher among women than men (8.4 vs 3.2 cases per 1000 person-years). Independent risks for early syphilis included multiple sex partners, HIV seroconversion, paid sex, and young age. All HIV seroconverters with syphilis were female. Conc lusions. Diagnosis of syphilis in drug-using women reflects high-risk sexual activity and is associated with acquiring HIV infection. Interv entions to reduce the risk of sexually acquired infections are urgentl y needed among female drug users.