THE IMPACT OF HIV-INFECTION ON THE INCIDE NCE OF SYPHILIS AND GONORRHEA AT A UNIVERSITY HOSPITAL (1985-1994)

Syphilis and gonorrhea are two sexually transmitted diseases (STD) whi ch still persist in spite of the existence of effective treatment. In this paper the incidence of these two diseases was evaluated between 1 985-1994, a decade during which the problem of HIV infection arose. Ev ery patient who attended the STD Program at the Hospital and was suspe cted of having syphilis and/or gonorrhea was clinically evaluated and was subjected to the following tests: a) search for Neisseria gonorrho eae (Ng) and penicinilase producers (PPNG) identification, b) search f or Treponema pallidum (Tp) by darkfield microscopy, c) serological stu dies for syphilis. From 1985 to 1991 the average of positive cases for Ng was 14.8% while from 1992 to 1994 it was 4.0% (p < 0,0001) showing a dramatic decrease between 1991 and 1992. PPNG increased from 8.7% i n 1985 to 44.6% in 1988 and then slowly decreased down to 26.9% in 199 4. From 1985 to 1990 the average of positive darkfield examinations wa s 20.7% while from 1991 to 1994 it was 12.2% (p < 0,0001). Between 198 5 to 1988 syphilis serological studies showed 45.7% positive cases dro pping to 34.3% between 1989 and 1994 (p < 0.0001). HIV infection appea rance had a wide repercussion throughout the world generating behavior al and sexual habit changes which have probably helped to prevent thes e two STD. Gonorrhea incidence was also influenced by the appearance o f new effective treatments, even against PPNG, such as fluorated quino lones and third generation cephalosporines. The population studied bel ongs to the most crowded area in Argentina, so that these observations should not be extrapolated to the rest of the country.