Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
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Reuters (11.03.09) - Thursday, November 05, 2009
Laura MacInnis
The comeback of syphilis has been fueled by the economic boom that began in the 1980s, the boom's attendant sex workers, their migrant-laborer clients, and poor health controls, Chen said.
"The areas with higher syphilis prevalence are usually places where the economy is booming but where there is also greater economic inequality, such as the south-eastern coastal areas," Chen said.
In 2008, China had 278,215 reported syphilis cases, triple the number in 2004 and a 10-fold increase over the past decade, Chen said. "On average, syphilis cases are increasing by 30 percent a year across the nation," he said.
Migrant workers, typically young men away from their wives, make up many of the clients of "low-tier" sex workers, Chen said. Compared with prostitutes working in "star-rated" hotels, low-tier sex workers are less aware of STD risks and are poorly educated, he said. Since they serve very poor clients, the women are often too poor to afford a condom or visit a specialized doctor, he explained.
In a 2008 national survey, the syphilis infection rate among men who have sex with men was 11.9 percent, and 4.9 percent had HIV.
Many people fear social stigma at public hospitals' STD departments. Privacy and confidentiality there are "not very well protected," Chen acknowledged, though reforms have been introduced in recent years.
In addition, Chen's agency is working in collaboration with WHO to offer point-of-care, rapid syphilis testing, which enables control efforts to target to non-traditional venues, Chen said.
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