Syphilis and HIV co-infection in patients attending HIV outpatient’s clinic in Makurdi, North central Nigeria: A cohort study

Introduction: Syphilis co-infection continues to be a persistent public health challenge and gaining renewed attention in the background of HIV infection and the era of HAART especially in developing countries like Nigeria. This study aims to assess the prevalence of HIV-syphilis co-infection and investigate the factors associated with syphilis in HIV patients on antiretroviral therapy (ART) in Makurdi, Benue State Methods: A total of 250 study participants were involved in a cohort study design using a consecutive sampling technique. A pre-tested structured interviewer questionnaire was used to collect data on socio-demographic, risk factors and clinical characteristics. History of syphilis co-infection were isolated based on patient’s clinical history, while the prevalence study involved a high index of suspicion from clinical sign and symptoms as well as a rapid plasma reagin (RPR) test (Bio-Rad France) and the non-treponemal serologic test used to screen blood samples for syphilis. Chi square was used to test association between socio-demographic and syphilis co-infection while binary regression analysis was used to test for independent predictors of syphilis co-infection. All test were carried out at 95% confidence level using SPSS version 26.0 Results: The syphilis co-infection among people living with HIV in this study was found to be 6.4%. Only age (p=0.035) and level of education (p=0.005) were significantly associated with syphilis co-infection. Higher co-infection was observed in respondents ≥ 25 years (50.0%) and respondents who had only secondary level of education (12.7%). There was a 4-fold and 2.7-fold increase in coming down with co-infection when an individual is ≥ 25 years and has no formal education respectively. Sex, religion, marital status, employment, having multiple sexual partners, prior history of syphilis infection, alcohol use, smoking and BMI were not significantly associated with syphilis co-infection. Conclusion: There is a substantial rate of syphilis co-infection among PLWHIV especial among respondents with low level of education and younger adults. STI counseling and screening on safe sex and primary prevention should be encouraged.