Factors Associated With Increased Syphilis Screening Among People Living With Human Immunodeficiency Virus

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Antiretroviral therapy reduces HIV transmission, but syphilis rates are rising, particularly among people living with HIV (PLWH).
• Oregon has seen a dramatic increase in syphilis cases, with many cases occurring in PLWH.
• Syphilis screening is often insufficient among PLWH, despite the rising incidence.

Purpose of the Study:

• To estimate the prevalence of past-year syphilis testing among PLWH in Oregon.
• To identify facility-level and individual-level factors associated with syphilis testing in PLWH.

Main Methods:

• Analysis of 2015-2016 Medical Monitoring Project data from Oregon.
• Inclusion of interview and medical records data, supplemented by provider interviews.
• Use of generalized mixed effects models to identify factors associated with syphilis screening.

Main Results:

• Sixty-nine percent of PLWH participants received syphilis screening in the past year.
• Patients at facilities with written sexually transmitted infection (STI) screening policies were significantly more likely to be screened (94% vs. 43%).
• Male participants were more likely to be tested, even after adjusting for facility characteristics.

Conclusions:

• Written STI screening policies are crucial for ensuring recommended syphilis screening rates.
• Implementing and enforcing such policies can help curb the rising incidence of syphilis.
• Targeted interventions may be needed to improve screening among specific populations or facilities lacking policies.