Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015-2016

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Diagnostic Test Evaluation

Background:

• The Syphilis Health Check (SHC) is a screening tool used in public health programs.
• Initial estimates suggested low specificity for SHC (91.5%) in a Florida county.
• Understanding SHC's real-world performance is crucial for effective syphilis control.

Purpose of the Study:

• To evaluate the specificity, positive predictive value (PPV), and programmatic impact of SHC in Florida.
• To assess field staff acceptance and utility of the SHC tool.
• To compare SHC outcomes with traditional syphilis testing methods.

Main Methods:

• Retrospective analysis of 3,630 SHC results from Florida publicly-funded programs (2015-2016).
• Survey of field staff regarding SHC utility and acceptance.
• Comparison of SHC results with syphilis diagnoses and subsequent testing outcomes.

Main Results:

• Estimated SHC specificity was 95.0%, with an overall positive predictive value (PPV) of 48.5%.
• PPV varied based on the prevalence of syphilis within tested populations.
• Field staff (90%) found SHC useful for identifying new cases, despite concerns about discordant results with lab testing.

Conclusions:

• SHC demonstrated improved specificity and utility in identifying new syphilis cases and facilitating partner testing.
• Enhanced programmatic outcomes, including shorter time to treatment, were observed with SHC use.
• Further research is recommended to address discordance issues and fully optimize SHC for syphilis mitigation strategies.