Scaling up syphilis testing in China: implementation beyond the clinic.

Area of Science:

• Public Health
• Epidemiology
• Infectious Diseases

Background:

• China is experiencing a large-scale syphilis epidemic.
• Syphilis prevalence is highest in regions also facing a significant sexually transmitted HIV threat.
• Many high-risk individuals in China do not receive routine syphilis screening due to barriers in accessing care and policy-practice gaps.

Purpose of the Study:

• To describe current syphilis control policies in China.
• To propose a spatiotemporal framework for enhancing syphilis screening and care.
• To advocate for syphilis control strategies extending beyond traditional clinical settings.

Main Methods:

• Review of current Chinese syphilis control policies.
• Development of a spatiotemporal framework for targeted screening.
• Emphasis on integrating non-traditional testing settings.

Main Results:

• Syphilis disproportionately affects regions with high HIV prevalence.
• Gaps in healthcare seeking behavior and policy implementation hinder screening efforts.
• Point-of-care syphilis testing offers a viable solution for non-traditional settings.

Conclusions:

• A comprehensive syphilis control strategy is needed in China.
• Integrating point-of-care testing into community and non-traditional settings can improve screening rates.
• A spatiotemporal approach targeting high-risk times and locations is essential for effective syphilis management.