Two hundred and thirty female and 43 male-to-female transsexual Greek prostitutes were screened for serological evidence of active syphilis as judged by positivity in both rapid plasma reagin (RPR) test and treponemal (FTA-ABS and TPHA) tests. The rate of active syphilis was 20.9% in the male-to-female transsexual prostitutes and 4.3% in the female ones (P < 0.001, odds ratio = 5.82). In the former group 65.1% had evidence of hepatitis B virus (HBV) infection, and 4.7% of hepatitis C virus (HCV) infection while the respective rates among the latter group were 50.4% and 3.9%. There was no correlation of viral hepatitis marker prevalence with positive syphilis serology.
PIP: A serologic study of 230 female and 43 male-to-female transsexual Greek prostitutes from the Greater Athens area failed to confirm an association between hepatitis infection and active syphilis. Study participants were recruited at presentation to the Ministry of Health venereal diseases clinic for periodic medical examination. Rapid plasma reagin and treponemal tests indicated 4.3% of female prostitutes and 20.9% of transsexuals had active syphilis infection. The rates of hepatitis B and hepatitis C virus were 50.4% and 3.9%, respectively, among female prostitutes and 65.1% and 4.7%, respectively, among transsexuals. Stratified analysis failed to detect any significant association between syphilis, hepatitis B surface antigen carriership, and exposure to hepatitis B or C infection within the two groups of sex workers. In addition, there was no significant association between syphilis, age of the sex worker, and years of legalized prostitution. It appears that, in these two populations, a syphilis diagnosis leads to intensive self-protective prevention measures against other sexually transmitted infections.