Integrating syphilis screening in a large-scale HIV prevention program for key populations: The Avahan experience from India

Mugundu R. Parthasarathy, Prakash Narayanan, Anjana Das, Anup Gurung, Parimi Prabhakar, Teodora Wi

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6 Citations (Scopus)


Introduction: Documented experiences from India on the implementation of syphilis screening in large-scale HIV prevention programs for "key populations at higher risk' (KPs) are limited. Avahan is a large-scale HIV prevention program providing services to more than 300,000 KPs in six high HIV prevalence states of India since 2004. Avahan clinics provide a sexually transmitted infection service package which includes bi-annual syphilis screening. The trends in the coverage of syphilis screening among Avahan clinic attendees were studied retrospectively. Methodology: Screening was performed using either the Rapid Plasma Reagin (RPR) test or point-of-care immunochromatographic strip test (ICST). Clinic records from 2005 to 2009 were collated in an individual tracking database and analyzed with STATA-10. Results: Initially the coverage of syphilis screening (2.6% in 2005) was constrained by the availability and operational complexity of the RPR test. After its introduction in 2007, the use of ICST for screening increased from 7.4% to 77.0% and the proportion of clinic attendees screened increased from 9.0% to 21.6% during 2007-2009. The RPR reactivity rates declined from 6.6% (2006) to 4.4% (2009). Conclusion: The data showed improved rates of screening of clinic attendees and declining trends in sero-reactivity over time. The introduction of point-of-care syphilis tests may have contributed to the improved coverage of syphilis screening. The ICST may be considered for initial syphilis screening at other resource-constrained primary care sites in India such as ante-natal clinics and other KP interventions.

Original languageEnglish
Pages (from-to)484-488
Number of pages5
JournalJournal of Infection in Developing Countries
Issue number6
Publication statusPublished - 25-06-2013

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Microbiology
  • Infectious Diseases
  • Virology


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