China’s Syphilis Epidemic: A Systematic Review of Seroprevalence Studies

OBJECTIVE: The objective of this study was to investigate syphilis prevalence among low- and high-risk groups in China. GOAL: The goal of this study was to explore the magnitude of China's syphilis epidemic. STUDY DESIGN: A systematic literature review of syphilis seroprevalence studies in China was performed searching PubMed and the Chinese Periodicals Database (CPD). RESULTS: Five and 169 studies were retrieved from PubMed and the CPD, respectively. From 2000 to 2005, select low-risk groups had the following median syphilis prevalence: antenatal women (0.45%), premarital individuals (0.66%), and food and service employees (0.3%). Select high-risk groups had the following median prevalence: incarcerated female sex workers (12.49%), drug users (6.81%), and men who have sex with men (14.56%). In the last decade, prevalence has increased in all groups with the steepest rises seen among high-risk groups. CONCLUSIONS: Syphilis infection is increasing among low- and high-risk groups in China, suggesting unsafe sexual behavior that may accelerate HIV transmission and challenge current syphilis prevention and control efforts.