Dataset Information

Social determinants of syphilis in South China: the effect of sibling position on syphilis and sexual risk behaviours.

ABSTRACT:

Objective

This study evaluated the relationship between sibling position and sexual risk based on behavioural and syphilis infection data from sexually transmitted infection (STI) patients in South China.

Design

A cross-sectional study examining sexual behaviours and syphilis infection.

Setting

4 STI clinics in the Pearl River Delta of South China.

Participants

1792 Chinese men and women attending STI clinics.

Primary outcome measures

STI history, syphilis infection defined as positive non-treponemal and treponemal tests.

Results

Among all clinic patients, 824 (46.3%) were first-born, 354 (19.9%) were middle-born and 602 (33.8%) were final-born. Middle-born individuals had a higher percentage of reported STI history (44.7% compared to 34.7%, p<0.001) and syphilis infection (9.7% compared to 4.9%, p=0.01) among men (n=1163) compared to other sibling positions in bivariate analyses, but not in the final multivariate model. The relationship between sibling position and syphilis was independent of income and education level. There was no trend observed between middle-born position and female sexual risk behaviours (n=626). Higher education was significantly associated with syphilis among women and men in respective multivariate models.

Conclusions

This study suggests that middle-born men in China may have an increased sexual risk compared to other sibling positions. As Chinese family and social structures change, a more thorough understanding of how demographic factors influence sexual risk behaviours is needed.

SUBMITTER: Tucker JD

PROVIDER: S-EPMC3657676 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Social determinants of syphilis in South China: the effect of sibling position on syphilis and sexual risk behaviours.

Tucker Joseph D JD Young Darwin D Yang Ligang L Yang Bin B Adimora Adaora A AA

BMJ open 20130528 5

<h4>Objective</h4>This study evaluated the relationship between sibling position and sexual risk based on behavioural and syphilis infection data from sexually transmitted infection (STI) patients in South China.<h4>Design</h4>A cross-sectional study examining sexual behaviours and syphilis infection.<h4>Setting</h4>4 STI clinics in the Pearl River Delta of South China.<h4>Participants</h4>1792 Chinese men and women attending STI clinics.<h4>Primary outcome measures</h4>STI history, syphilis inf ...[more]

PMID: 23793689

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Project description:Syphilis and congenital syphilis (CS) are increasing in California (CA). From 2015 through 2019, for example, CA cases of early syphilis among reproductive-age females (15-44) and CS each increased by >200%. Certain populations-including people experiencing homelessness, using drugs, and/or belonging to certain racial/ethnic groups-have been disproportionately impacted. We hypothesized that geospatial social determinants of health (SDH) contribute to such health inequities. To demonstrate this, we geospatially described syphilis in CA using the Healthy Places Index (HPI). The HPI is a composite index that assigns a score to each CA census tract based on eight socioeconomic characteristics associated with health (education, housing, transportation, neighborhood conditions, clean environment, and healthcare access as well as economic and social resources). We divided CA census tracts into four quartiles based on HPI scores (with the lowest quartile having the least healthy socioeconomic and environmental conditions), then used 2013-2020 CA sexually transmitted diseases surveillance data to compare overall syphilis (among adults and adolescents) and CS case counts, incidence rates (per 100,000 population or live births), and incidence rate ratios (IRRs) among these quartiles. From 2013 to 2020, across all stages of syphilis and CS, disease burden was greatest in the lowest HPI quartile and smallest in the highest quartile (8308 cases (representing 33.2% of all incidents) versus 3768 (15.1%) for primary and secondary (P&S) syphilis; 5724 (31.6%) versus 2936 (16.2%) for early non-primary non-secondary (NPNS) syphilis; 11,736 (41.9%) versus 3026 (10.8%) for late/unknown duration syphilis; and 849 (61.9%) versus 57 (4.2%) for CS; all with p < 0.001). Using the highest HPI quartile as a reference, the IRRs in the lowest quartile were 17 for CS, 4.5 for late/unknown duration syphilis, 2.6 for P&S syphilis, and 2.3 for early NPNS syphilis. We thus observed a direct relationship between less healthy conditions (per HPI) and syphilis/CS in California, supporting our hypothesis that SDH correlate with disparities in syphilis, especially CS. HPI could inform allocation of resources to: (1) support communities most in need of assistance in preventing syphilis/CS cases and (2) reduce health disparities.

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Dataset Information

Social determinants of syphilis in South China: the effect of sibling position on syphilis and sexual risk behaviours.

Objective

Design

Setting

Participants

Primary outcome measures

Results

Conclusions

Publications

Social determinants of syphilis in South China: the effect of sibling position on syphilis and sexual risk behaviours.

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