Epidemiology of primary and secondary syphilis in the United States, 1981 through 1989

Article Abstract:

While syphilis has become a relatively rare disease for most of the United States population, it remains a severe problem for blacks and Hispanic groups. It is particularly important to follow the rate of infection of sexually transmitted diseases, as increased prevalence heralds changes in the rate of HIV infection and thus the incidence of AIDS. In Africa, the presence of genital ulcers (chancres) such as occur with syphilis has been found to be associated with an increased rate of AIDS among heterosexuals. The nearly 50-fold increase in rate of syphilitic infection among American blacks may indicate an emerging rapid penetration of heterosexually spread AIDS in this country, as well. The present study examines the rate of infection of whites, blacks, Hispanics, and Native Americans between 1981 and 1989. In total number of cases of primary and secondary syphilis declined from a peak in 1982 until 1985, when it began increasing for the balance of the study period. Among white males, the incidence peaked in 1983 and began to decline through the remainder of the study period. During the period 1982-1985 there was a similar decline in the occurrence rates for black men and women. However, in 1986 the rates for both began to increase markedly. The increase was geographically widespread, but the incidence among blacks doubled in 22 states, and in the District of Columbia and 10 other states it increased by more than 400 percent. There was little change for white women or Asian/Pacific Island women. The number of cases reported for Native Americans was so low, fewer than 100 cases, that no trend was evident. The rate of occurrence in Hispanics was intermediate between the rates found for whites and blacks. The decline among white men has been shown to be largely dependent on the change of sexual practices among white homosexual and bisexual men. These changes most probably occurred as a result of the practice of safer sexual behavior to avoid HIV infection. Because of the potential effect on the transmission of AIDS, treatment, screening and partner notification of infections caused by syphilis should be intensified, and the syphilis epidemic should be made a public health priority. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Risk factors, Syphilis, Race

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Acquired immunodeficiency syndrome - Europe

Article Abstract:

By March 31, 1990, 35,376 cases of AIDS had been reported by the 32 countries in the World Health Organization's European Region (EURO). This constituted an increase of 61.9 percent over the previously reported total of March 1989. Slightly more than 45 percent of the total number of cases were in homosexual or bisexual men; another 30 percent involved intravenous drug users (IVDUs); 8 percent were people that had heterosexual contact with an infected or high-risk person; and between 3 and 4 percent represented transfusion recipients and persons with disorders of blood coagulation. Just under 13 percent of the total adult AIDS cases were women, more than half of whom were IVDUs. The cumulative AIDS incidence rates (new cases, per million population) were highest in Switzerland, France, Spain, Denmark, and Italy. The highest rate was in Switzerland (190.2 per million), which can be compared with the rate in the US (515.7 per million). Eastern European countries reported low rates. In Northern Europe, 70 percent of all cases occurred among homosexual or bisexual men, while IVDUs made up approximately two thirds of the cases in Italy and Spain. Pediatric AIDS cases (people younger than 13) accounted for 1,199 cases, half of whom came from France, Italy, or Spain. These cases were largely the result of mother-child transmission. Of the 241 pediatric cases reported in Romania, most had undergone multiple hospitalizations and injections, and were hospital-acquired. The greatest increases between 1989 and 1990 were reported by Eastern European countries, perhaps because of improved surveillance and reporting. Because outbreaks such as the one in Romania testify to the importance of proper sterilization practices in hospitals, the Romanian Ministry of Health, the World Health Organization, and the Centers for Disease Control have set up a program to improve AIDS surveillance in that country. Epidemiologic studies are underway, with the ultimate goal of improving efforts toward AIDS prevention in Romania. (Consumer Summary produced by Reliance Medical Information, Inc.)

Europe, Statistics, Romania

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Acquired immunodeficiency syndrome associated with intravenous-drug use - United States, 1988

Article Abstract:

In 1988, 9,752 cases of acquired immunodeficiency syndrome (AIDS) were reported in intravenous-drug users (IVDUs), their sex partners, and children born to mothers who were IVDUs or sex partners of IVDUs. These IVDU-associated AIDS cases represented 33 percent of the 32,311 cases of AIDS reported in the U.S. in 1988: 53.9 percent were male heterosexual IVDUs, 16.2 percent were female IVDUs, 19.1 percent were male bisexual IVDUs, 5.8 percent were women whose heterosexual partners were IVDUs, 2.1 percent were men whose heterosexual partners where IVDUs, 2.1 percent were children whose mothers were IVDUs, and 0.8 percent were children whose mothers were sex partners of IVDUs. The proportion of IVDU-associated AIDS cases has been higher in the Northeast than in any other region of the U.S. Studies show that IVDUs infected with the human immunodeficiency virus (HIV) suffer from more infections (e.g., increased rates of pneumonia-related deaths) than do non-IVDU AIDS patients. The epidemiology of IV- drug uses poses a serious challenge to the efforts to prevent and control HIV infection and AIDS among IVDUs. Increasingly, cocaine and other drugs are being used intravenously. Prevention of HIV infection in IV-cocaine users is further complicated because those persons engage in more frequent injection and needle sharing than do other IVDUs (e.g., heroin users). Unlike methadone therapy for treatment of heroin dependence, there is no specific therapy for treating cocaine dependence.

Complications and side effects, Drug abuse, column, Injections, Intravenous, Intravenous injections

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