Human immunodeficiency virus and syphilis seropositivity among patients attending clinic for sexually transmitted disease.

In India the spread of HIV has been predominantly attributed to heterosexual transmission with much higher seropositivity among patients with sexually transmitted diseases (STDs). However statistics from New Delhi reflect a lower seroprevalence of HIV among patients attending STD clinics compared with Mumbai. The authors undertook a study to determine the seroprevalence of HIV among patients with STDs at a hospital in New Delhi. They further assessed the relationship between HIV and syphilis among high-risk groups. From January to August 1999 serum from 305 patients with a suspected STD were tested for syphilis and HIV by the Venereal Disease Research Laboratory and by enzyme-linked immunosorbent assay/rapid/simple assay respectively. Of the 305 screened 68 (22.3%) patients were positive for syphilis and 32 (10.5%) were HIV-1 antibody positive. Of those with positive syphilis serology 13 (19.1%) were HIV positive. HIV seropositivity was found to be significantly associated with positive syphilis serology (odds ratio 2.71; 95% confidence interval 1.27-5.76). These findings indicate that patients with primary syphilis were at higher risk of HIV suggesting that control of syphilis at an early stage may play an important role in controlling HIV infection in India.