Illicit drug trade has re-emerged in China since 1979 and the number of drug addicts had increased much. Syphilis is a chronic infectious disease mainly spread through sexual contact and blood. The incidence of syphilis was 27.9% among drug users. Methadone maintenance treatment clinics were implemented in China since 2004. Although methadone maintenance treatment clinic was set up in order to prevent the HIV/AIDS epidemic, we found that there were a lot of drug addicts with syphilis. The aim of this study was to estimate the prevalence and risk factors of syphilis among drug users at methadone maintenance treatment clinics in China between 2004 and 2013.

Chinese and English database (CBM, CNKI, Weipu, Pubmed) of literature were searched for studies reporting syphilis among drug users in methadone maintenance treatment clinics from 2004 to 2013. The prevalence estimates and risk factors were summarized through a systematic review and meta-analysis of published literatures. All analyses were carried out using the statistical software package R version 2.13.1.

In all, 29 eligible articles with a total of 8899 drug users, study year from 2004 to 2012, were selected in this review. The pooled prevalence of syphilis infection was 7.78% (95%CI: 5.83%–9.99%). The meta-analyses demonstrated significant difference in syphilis infection rates between men and women (OR = 0.34 [95%CI: 0.26–0.45]) and not significant difference between drug users and non-intravenous drug users (OR = 0.82 [95%CI: 0.51–1.32]).

Enhance the detection of syphilis at methadone maintenance treatment clinics, strengthen the protection of female and non-intravenous drug users should be the key point of our work in future. We should strengthen the propaganda education and behavioral interventions among drug users.