Sexually transmitted infections (STIs) are not new to China. However, a resurgence, particularly of syphilis, has been observed in the 1980s and 1990s. Driven by the sweeping political, economic, and social reforms of the late 1970s, syphilis has emerged as the third most-commonly reported infectious disease. Although inexorably linked to the emergence and expansion of China’s HIV epidemics, China’s syphilis response has lagged and been plagued by lack of recognition and lack of funding. Nevertheless, prevention and control efforts have grown with advances in treatment, testing, surveillance, and case reporting. Over the past decade, new national policies have prioritized syphilis prevention and control, and observational studies have improved our understanding of the syphilis epidemic among key, at-risk populations. Yet, many challenges remain—late presentation to testing and treatment is all too common, clinical services are not fully standardized, STI screening coverage still needs to be expanded, sexual health education should be improved, human resource and laboratory capacity needs to be increased, and stigma and discrimination must be eliminated. The syphilis response could benefit greatly from being more integrated into the HIV response, and China should look for opportunities to provide its citizens integrated prevention, testing, treatment, and care services.
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The authors would like to thank Chu Zhou, Xianlong Ren, Peili Wu, Xiaoai Qian, and Jun Chen for assistance in manuscript preparation.
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