Syphilis serology among transvestite prostitutes attending an HIV unit in Rome, Italy

Sixty-seven transvestite prostitutes from Latin America (49 from Brazil and 18 from Colombia) who attended an HIV unit located in the inner city of Rome between January 1991 and June 1992 were studied for syphilis markers by means of both the Treponema pallidum haemoagglutination test (TPHA) and a solid phase haemadsorption test for detection of specific IgM (SPHA-IgM) which are typically present in recent infections. All participants reported more than 500 sexual partners in the past year, and 67.1% of them more than 1500 partners (between 5 and 10 partners per working day). The overall prevalence of anti-HIV antibodies in this population was 65.7%. The prevalence of positive TPHA tests in the population studied was 73.1%, while that of positive SPHA-IgM tests was 10.4%. The prevalence of positive TPHA and SPHA-IgM tests was higher among Columbians than among Brazilians (83.3% vs 69.4% and 22.2% vs 6.1%, respectively) and also showed a positive correlation with the duration of their permanence in Italy. The TPHA and SPHA-IgM positivities were significantly higher among subjects older than 29 years. Positive TPHA was also significantly higher in subjects who reported a history of heroin and/or cocaine abuse while positive SPHA-IgM was higher in subjects who did not use condoms or reported irregular use of them than in subjects who regularly used condoms. No overall correlation was evident between TPHA positivity and anti-HIV positivity, while SPHA-IgM positivity was found to be higher among anti-HIV-negative subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Absence of T cell impairments in a unique group of anal-receptive transvestite and male prostitutes in Israel

High rates of immunologic abnormalities in asymptomatic, clinically healthy urban homosexual men have been associated with promiscuous, unprotected receptive rectal intercourse, and related to infection by the human immunodeficiency virus (HIV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV). In cohort studies in Israel, which is still a low risk country for HIV infection and AIDS, about 40% of asymptomatic, clinically healthy male homosexuals consistently showed T cell defects that were not correlated with anal-receptive sexual behavior and were independent of HIV antibody status. Since pre-existing immune impairments in HIV-seronegative individuals have been implicated as a risk factor for seroconversion, we have attempted to investigate more precisely the role of anal-receptive homosexual activity as a risk factor for the acquisition of immune defects. We compared T lymphocyte profiles and mean geometric titers of EBV and CMV in a homogeneous group of 14 transvestite and male anal-receptive homosexual prostitutes with those of 77 HIV-seronegative male homosexuals who were not exclusively anally passive with multiple sex partners. While 44% of the control group showed a decrease of total T cells or their subpopulations as compared with normal heterosexual men (P less than 0.001), T lymphocyte values of the anal-receptive prostitutes were within the normal range. In the prostitutes, serum antibodies to HIV were detected in only 1 individual, to CMV in 12 of 13, and to EBV in all. Despite high mean geometric titers of antibodies to CMV (86.6) and EBV (25.8), frequent anal-receptive intercourse was not sufficient, in itself, to cause immune impairment in this unique group. The results suggest that the problem of cofactors contributing to immune deficiency in male homosexuals should be reexamined in countries with a low incidence for HIV seropositivity and AIDS.