SYPHILIS SEROLOGY AMONG TRANSVESTITE PROSTITUTES ATTENDING AN HIV UNIT IN ROME, ITALY

Sixty-seven transvestite prostitutes from Latin America (49 from Brazi l 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 syphi lis markers by means of both the Treponema pallidum haemoagglutination test (TPHA) and a solid phase haemadsorption test for detection of sp ecific 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 part ners per working day). The overall prevalence of anti-HIV antibodies i n this population was 65.7%. The prevalence of positive TPHA tests in the population studied was 73.1%, while that of positive SPHA-IgM test s was 10.4%. The prevalence of positive TPHA and SPHA-IgM tests was hi gher 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 positivi ties were significantly higher among subjects older than 29 years. Pos itive TPHA was also significantly higher in subjects who reported a hi story of heroin and/or cocaine abuse while positive SPHA-IgM was highe r in subjects who did not use condoms or reported irregular use of the m than in subjects who regularly used condoms. No overall correlation was evident between TPHA positivity and,anti-HIV positivity, while SPH A-IgM positivity was found to be higher among anti-HIV-negative subjec ts. The population studied, therefore, apparently represents a relevan t source for syphilis (in addition to HIV) transmission, due to the hi gh number of sexual partners and to the overall irregular use of condo ms, and it is likely that similar populations can largely contribute t he maintenance of syphilis in industrialized countries. Fluorescent an ti-treponemal antibody-absorption (FTA-ABS) and rapid plasma reagin (R PR) tests were also performed on all serum samples. Results of FTA-ABS were fully consistent with those of TPHA, while a lower degree of con cordance was observed between RPR and TPHA.