A Case Series of Syphilis in Gender Incongruent Individuals Residing in an Urban Slum of a Metropolitan city: Are we letting down the Guard of Contact Tracing?

Abstract

Introduction: In India, Sexually transmitted infections (STI) have variability in prevalence across different
subregions and subpopulations practicing high-risk behavior (the gender incongruent individuals, commercial
sex workers, truck drivers etc.). Prevalence of syphilis in gender incongruent individuals is a gray area due to
stigma and discrimination associated with the diagnosis. Contact tracing is a boon in better handling the public
health burden of STIs. The current case series is to highlight the resurgence of syphilis in gender incongruent
individuals and to underscore the importance of screening and contact tracing for the same for public good.
Methods: Twenty one gender incongruent individuals testing positive for Syphilis with the Rapid Reagin Test
(RPR) in a period of a year at the Malvani Urban Health Training Center (UHTC), Malvani Slum, Malad, Mumbai;
were included in the study.
Results: The RPR titres ranged from 1:2 to 1:64. Out of these twenty one, 4 of them were found to be HIV coinfected.
They were counseled and treated according to the standard guidelines. Contacts of partners whom they
had intercourse with, in past 3 months could not be traced, as a result of which partner management couldn’t be
done.
Conclusions: Better patient awareness through counseling and incorporation of information technology can aid in
tackling the problem of non compliance with contact tracing. Active screening for HIV should be done in patients
with STI.