Abstract
Background: Sexual health among older adults is a major public health concern globally. The syphilis burden is increasing in older adults in China. This study aimed to describe factors associated with syphilis infection and diagnosis among older adults in China during a 16 year period.Methods: Using 16 years of data (2004–2019) from the syphilis case report system of Guangdong, China, we compared data from older adults (aged ≥50 years) with those from younger people (aged 15–49 years). We compared the two age group with the Chi-square test for difference, and Joinpoint regression models to assess the temporal trends.Results: During the study period, 242,115 new syphilis diagnoses were reported in older adults. The mean notification rate of new diagnoses was 64.1 per 100,000 population across the entire 16-year period, which significantly increased over time (average annual percent change [AAPC] 16.2%, 95% CI 13.7–18.7). Syphilis diagnoses increased significantly over time among less developed cities and older women. In 2019, compared with younger adults, newly diagnosed older adults were more likely to be male, native to reporting city, had unknown transmission routes, and were diagnosed late.Conclusion: Our findings call for an urgent need to deliver more targeted prevention interventions for older adults, such as strengthen awareness among health care providers, and integration of syphilis services and primary health care for older adults.
Highlights
Sexual health among older adults is a major public health concern globally
This study aims to describe factors associated with syphilis infection and diagnosis among adults aged 50 years or older by analysing new syphilis diagnoses reported in Guangdong Province, a high transmission region of southern China, using 16 years of data (2004–2019) from the provincial case report system
Among older adults diagnosed in 2019, men had a higher new syphilis diagnoses compared with women, with a male-tofemale ratio of 1.8
Summary
Sexual health among older adults is a major public health concern globally. The syphilis burden is increasing in older adults in China. The global population is rapidly ageing, with a predicted 22% increase in those aged 60 years or older from 800 million in 2011 to 2 billion people in 2050 [1] This presents a major global public health challenge in light of a growing burden of disease, which corresponds to a need for robust health care systems to adapt to evolving demands, and a call to invest in healthy ageing policies and programs throughout the world [2]. Increasing coverage and uptake of syphilis testing in older adults to promote early diagnosis and treatment is challenging for health care professionals [4]. This may be even more difficult due to the COVID-19 pandemic. Epidemiological research on syphilis is necessary to inform testing, treatment, and control of syphilis
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