Provincial residence and active syphilis infection among Zambian men and women

Antonia M. Welch, Harvard University

We examined risk factors for active syphilis infection in a subset of a nationally-representative, population-based survey of Zambian men and women. Syphilis prevalence was 6.5% for women (N = 2107) and 7.4% for men (N = 1745). In the multivariate model, province was a strong risk factor for active syphilis infection, with Copperbelt Province conferring the highest risk for women (OR = 5.17, 95% CI 1.90 - 14.07) and Eastern Province conferring the highest risk for men (OR = 4.74, 95% CI 1.70 - 13.24). In addition to province, age, education, age at first intercourse, marital status, history of genital sore or discharge, and having ever paid for sex were independent predictors of syphilis infection. Given the ongoing HIV-1 epidemic in Zambia, more aggressive diagnosis and treatment of active syphilis infections, particularly in high-risk provinces, are important strategies to reduce reproductive morbidity and curb HIV-1 transmission