Dual epidemics of syphilis and methamphetamine use among drug users in Shandong Province of China

Abstract

We assessed the types of drugs, the prevalence of HIV, syphilis, and its correlates among Shandong's drug users in China. Two consecutive cross-sectional surveys in 2009 and 2010 provided demographics, types of drugs, sexual and drug-use behaviors, and HIV-related services. Of the 1320 unique, eligible participants, 81.1% were male, two-thirds <35 years of age, 13.0% non-Shandong residents; in the past year, majority (96.4%) reported ever using methamphetamine, 3.4% using heroin, 8.6% using ≥2 types of these drugs and 8.0% injecting drugs, 63.8% having commercial sex. HIV and syphilis prevalence were 0.2% and 8.3%, respectively. In multivariable logistic regression analysis, syphilis was independently associated with female, non-Shandong residents, higher levels of education, and 2010. Synthetic drugs, especially methamphetamine, have become the predominant sources of drug addiction. The emerging epidemic of syphilis potentially driven by methamphetamine use underscored the urgency to implement an effective sex and substance use-related intervention.

Keywords:

• syphilis
• epidemic
• methamphetamine
• drug use
• sexual behavior

Acknowledgements

We are grateful to the study health staff from local Center for Disease Control and Prevention (CDC) for their efforts in participating in the research training and recruiting study participants, and to the participants for sharing their time and experiences. This study was supported by the National Center for AIDS/STD Control and Prevention of the China Center for Disease Control and Prevention (CDC), China-US Cooperation Global AIDS Program, and the Institute for Global Health and Department of Preventive Medicine of Vanderbilt University.