Integrated HIV and STIs response: Trends in syphilis incidence and uptake of oral pre-exposure prophylaxis in Zambia
Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) was introduced in Zambia to prevent transmission, but it does not protect against sexually transmitted infections (STIs) such as syphilis. Globally, STIs have risen alongside PrEP rollout, posing significant public he...
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| Format: | Article |
| Language: | English |
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AOSIS
2025-07-01
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| Series: | Journal of Public Health in Africa |
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| Online Access: | https://publichealthinafrica.org/index.php/jphia/article/view/1306 |
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| author | Kutha Banda Nicholus C. Sande Chipwaila C. Chunga Belia Longwe Kayawe Nkumbwa Madaliso Silondwa Nsanzya Maambo Japhet Michelo Prudence Haimbe Trevor Mwamba Hilda Shakwelele Sandra Chilengi-Sakala Ireen Bwalya |
| author_facet | Kutha Banda Nicholus C. Sande Chipwaila C. Chunga Belia Longwe Kayawe Nkumbwa Madaliso Silondwa Nsanzya Maambo Japhet Michelo Prudence Haimbe Trevor Mwamba Hilda Shakwelele Sandra Chilengi-Sakala Ireen Bwalya |
| author_sort | Kutha Banda |
| collection | DOAJ |
| description | Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) was introduced in Zambia to prevent transmission, but it does not protect against sexually transmitted infections (STIs) such as syphilis. Globally, STIs have risen alongside PrEP rollout, posing significant public health concerns that require urgent attention and targeted intervention strategies.
Aim: We examined trends in syphilis incidence and assessed its association with PrEP use, given the increasing global burden of STIs, including among PrEP users between 2021 and 2023.
Setting: Among individuals in Zambia.
Methods: A retrospective database analysis of secondary data was conducted using District Health Information Software 2 (DHIS2), the Ministry of Health’s primary data system. Microsoft® Excel and Stata were used for descriptive statistics and regression analysis to examine potential associations.
Results: From 2021 to 2023, syphilis cases (199 273) and PrEP initiation (436 460) increased annually. Syphilis cases rose from 22% to 46%, while PrEP initiation grew from 22% to 48%. We found a positive association between syphilis incidence and PrEP initiation, with each unit increase in PrEP initiation corresponding to a 0.33-unit rise in syphilis cases (p 0.001; 95% confidence interval [CI]: 0.25–0.4), underscoring this relationship.
Conclusion: This analysis found a significant positive link between syphilis incidence and PrEP initiation, emphasising the need for integrated HIV and STI management to enhance public health interventions.
Contribution: This study provides valuable insights for policy and programme implications; it highlights the importance of integrating STI prevention into HIV prevention service delivery; an integrated approach is critical to ensure that the country does not regress the achievements made towards HIV epidemic control. |
| format | Article |
| id | doaj-art-2346b6cdb0a64201af3e6e0165db19cf |
| institution | DOAJ |
| issn | 2038-9922 2038-9930 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Journal of Public Health in Africa |
| spelling | doaj-art-2346b6cdb0a64201af3e6e0165db19cf2025-08-20T03:23:11ZengAOSISJournal of Public Health in Africa2038-99222038-99302025-07-01161e1e910.4102/jphia.v16i1.1306888Integrated HIV and STIs response: Trends in syphilis incidence and uptake of oral pre-exposure prophylaxis in ZambiaKutha Banda0Nicholus C. Sande1Chipwaila C. Chunga2Belia Longwe3Kayawe Nkumbwa4Madaliso Silondwa5Nsanzya Maambo6Japhet Michelo7Prudence Haimbe8Trevor Mwamba9Hilda Shakwelele10Sandra Chilengi-Sakala11Ireen Bwalya12Clinton Health Access Initiative, Lusaka, Zambia; and Women in Global Health Zambia, LusakaNational AIDS Council, LusakaDepartment of Research, National Health Research Authority, LusakaClinton Health Access Initiative, Lusaka, Zambia; and Women in Global Health Zambia, LusakaDepartment of Policy and Planning, National AIDS Council, LusakaClinton Health Access Initiative, LusakaNational Health Research Authority, LusakaClinton Health Access Initiative, LusakaClinton Health Access Initiative, LusakaDepartment of Public Health, Clinton Health Access Initiative, LusakaClinton Health Access Initiative, LusakaNational Health Research Authority, LusakaMinistry of Health, LusakaBackground: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) was introduced in Zambia to prevent transmission, but it does not protect against sexually transmitted infections (STIs) such as syphilis. Globally, STIs have risen alongside PrEP rollout, posing significant public health concerns that require urgent attention and targeted intervention strategies. Aim: We examined trends in syphilis incidence and assessed its association with PrEP use, given the increasing global burden of STIs, including among PrEP users between 2021 and 2023. Setting: Among individuals in Zambia. Methods: A retrospective database analysis of secondary data was conducted using District Health Information Software 2 (DHIS2), the Ministry of Health’s primary data system. Microsoft® Excel and Stata were used for descriptive statistics and regression analysis to examine potential associations. Results: From 2021 to 2023, syphilis cases (199 273) and PrEP initiation (436 460) increased annually. Syphilis cases rose from 22% to 46%, while PrEP initiation grew from 22% to 48%. We found a positive association between syphilis incidence and PrEP initiation, with each unit increase in PrEP initiation corresponding to a 0.33-unit rise in syphilis cases (p 0.001; 95% confidence interval [CI]: 0.25–0.4), underscoring this relationship. Conclusion: This analysis found a significant positive link between syphilis incidence and PrEP initiation, emphasising the need for integrated HIV and STI management to enhance public health interventions. Contribution: This study provides valuable insights for policy and programme implications; it highlights the importance of integrating STI prevention into HIV prevention service delivery; an integrated approach is critical to ensure that the country does not regress the achievements made towards HIV epidemic control.https://publichealthinafrica.org/index.php/jphia/article/view/1306syphilispre-exposure prophylaxisincidencesexual healthtrend analysis |
| spellingShingle | Kutha Banda Nicholus C. Sande Chipwaila C. Chunga Belia Longwe Kayawe Nkumbwa Madaliso Silondwa Nsanzya Maambo Japhet Michelo Prudence Haimbe Trevor Mwamba Hilda Shakwelele Sandra Chilengi-Sakala Ireen Bwalya Integrated HIV and STIs response: Trends in syphilis incidence and uptake of oral pre-exposure prophylaxis in Zambia Journal of Public Health in Africa syphilis pre-exposure prophylaxis incidence sexual health trend analysis |
| title | Integrated HIV and STIs response: Trends in syphilis incidence and uptake of oral pre-exposure prophylaxis in Zambia |
| title_full | Integrated HIV and STIs response: Trends in syphilis incidence and uptake of oral pre-exposure prophylaxis in Zambia |
| title_fullStr | Integrated HIV and STIs response: Trends in syphilis incidence and uptake of oral pre-exposure prophylaxis in Zambia |
| title_full_unstemmed | Integrated HIV and STIs response: Trends in syphilis incidence and uptake of oral pre-exposure prophylaxis in Zambia |
| title_short | Integrated HIV and STIs response: Trends in syphilis incidence and uptake of oral pre-exposure prophylaxis in Zambia |
| title_sort | integrated hiv and stis response trends in syphilis incidence and uptake of oral pre exposure prophylaxis in zambia |
| topic | syphilis pre-exposure prophylaxis incidence sexual health trend analysis |
| url | https://publichealthinafrica.org/index.php/jphia/article/view/1306 |
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