A prospective study of syphilis and HIV infection among injection drug users receiving methadone in the Bronx, NY

Am J Public Health. 1996 Aug;86(8):1112-5. doi: 10.2105/ajph.86.8_pt_1.1112.


Objectives: The purpose of this study was to assess the relationship between syphilis and human immunodeficiency virus (HIV) infection in injection drug users.

Methods: A 6-year prospective study of 790 injection drug users receiving methadone maintenance treatment in the Bronx, NY, was conducted.

Results: Sixteen percent (4/25) of HIV-seroconverting patients, 4.8% (16/335) of prevalent HIV-seropositive patients, and 3.5% (15/430) of persistently HIV-seronegative patients was diagnosed with syphilis. Incidence rates for early syphilis (cases per 1000 person-years) were 15.9 for HIV-seroconverting patients, 8.9 for prevalent HIV-seropositive patients, and 2.9 for persistently HIV-seronegative patients. Early syphilis incidence was higher among women than men (8.4 vs 3.2 cases per 1000 person-years). Independent risks for early syphilis included multiple sex partners, HIV seroconversion, paid sex, and young age. All HIV seroconverters with syphilis were female.

Conclusions: Diagnosis of syphilis in drug-using women reflects high-risk sexual activity and is associated with acquiring HIV infection. Interventions to reduce the risk of sexually acquired infections are urgently needed among female drug users.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • HIV Infections / etiology*
  • Humans
  • Incidence
  • Male
  • Methadone / therapeutic use*
  • Narcotics / therapeutic use*
  • New York City
  • Prospective Studies
  • Risk Factors
  • Sex Distribution
  • Sexual Behavior*
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / drug therapy
  • Syphilis / etiology*
  • Urban Health


  • Narcotics
  • Methadone