Related Experiment Videos
Syphilis in Atlanta during an era of declining incidence
D T Fleming1, W C Levine, D L Trees
1Division of STD Prevention, National Center for HIV, STD and TB Prevention. Flemindt@umdnj.edu
Background:
Syphilis transmission in Atlanta is ongoing despite declining incidence.
Objectives:
To identify risk factors and missed opportunities for prevention.
Study Design:
A case-control study design was used. Twenty-five sexually transmitted disease (STD) clinic patients with primary or secondary syphilis by polymerase chain reaction and serology and 49 matched controls were interviewed.
Results:
Persons with syphilis more frequently had HIV infection (24% versus 2%; P = 0.005), crack-using sex partners (52% versus 18%; odds ratio [OR] = 5.1; 95% CI = 1.7-15.5), and a history of incarceration (80% versus 57%; OR = 3.0; CI = 1.0-9.3). Many cases (48%) and controls (31%) had received drug-abuse treatment. Only 40% of previously incarcerated patients and 74% of those with a history of drug treatment reported receiving STD/HIV education in those settings. Among all patients reporting recent HIV education, 41% were told about STD recognition and treatment. Unprotected sex and delay in seeking care were common.
Conclusion:
To prevent syphilis and associated HIV, more extensive STD education is needed in jails and drug-treatment centers.