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Other Comments:
This is a valuable study of risk factors for syphilis among IV durg users in China. One valuable aspect of this study was the potential to serve as a model for studying (and preventing) HIV transmission. This was a stated goal of the authors. As such, it seems the title is somewhat misleading - it would be appropriate to mention HIV/AIDS in the title.
The grammer and phrasing needs improvement to make the article more "readable."
The discussion is somewhat repetitive; many of the authors conclusions are actually based on the results of referenced studies rather than the current study. It would be helpful if the authors included a concise conclusion at the end of the discussion.
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Competing interests:
None
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Invited by the author to review this article? :
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Have you previously published on this or a similar topic?:
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References:
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Experience and credentials in the specific area of science:
Medical Director for Public Health - Dayton & Montgomery County
- How to cite: Herchline T .Syphilis Infection Among Drug Users in Different Regions in China[Review of the article 'Syphilis Infection Among Drug Users in Different Regions in China: Develop Targeted Intervention Strategy ' by Lv F].WebmedCentral 2017;2(10):WMCRW001065
The main claims of the paper are that syphilis prevalence is between 9.6-17.5% in the three cities studied, and that female gender was positively associated with syphilis status in all three cities. In one city, being married and having less education were also positively associated with syphilis status. Although similar information exists in the literature, this is valuable information even if not insightful.
Unfortunately, even at the time that this paper was published on Webmed Central, there was already a substantial amount of literature available on syphilis and HIV prevalence and risk factors. In addition, many of these studies were conducted in China, some even in the same cities and among drug users. The author's estimations of syphilis prevalence are above what most report, but there have been some other studies in line with the reported prevalence. Overall, this paper does not add a sufficient amount of novel and gainful information to the literature.
Following please see a few of the papers that had been published at the time of this paper's acceptance:
Poon, A et al. AIDS Care 23 Suppl 1 (June 2011): 5–25.
Wang, H. et al. Epidemiology and Infection 139, no. 9 (September 2011): 1401–9
He, Qun, et al. The Southeast Asian Journal of Tropical Medicine and Public Health 42, no. 3 (May 2011): 616–33.
Wu, Jie, et al. BMC Public Health 10 (November 1, 2010): 657.
Wang, Haibo, et al. Drug and Alcohol Dependence 113, no. 1 (January 1, 2011): 37–45.
While the idea that syphilis risk factors might somehow inform HIV prevention measures is interesting, not enough is done to connect these two ideas. The authors might consider making the connection more clear.
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The survey design was thoroughly described and limitations discussed.
The authors might consider providing an explanation for why the logistic regression was performed separately for each of the three sites. If no compelling reason is available, it would make more sense to run the regression on the entire sample, possibly including site as a covariate or stratification. This would not be immensely difficult, but I believe would add to the generalizability.
Unfortunately, the claims in this paper are neither novel nor gainful. Much insight might be gained from the surveys collected, but the way in which the authors attempt to extrapolate their results to HIV is strained at best. Much research into syphilis prevalence and risk factors, even amongst IV drug users in China, has already been published.
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I have received a PharmD and MS in pharmaceutical sciences and have taken many classes on STIs. In additional, I am currently pursuing a PhD in Pharmaceutical Outcomes and Policy with a specialization in pharmacoepidemiology.