Risk factors for treatment non-completion among patients with syphilis

With recent increases in syphilis, there is growing interest in expanding screening; however, treatment rates have historically been low.

This study examines demographic and clinical factors that may contribute to non-completion of syphilis treatment.

This is a retrospective comparative cohort study of all patients with syphilis from January through November 2018 at an urban, tertiary care hospital.

Demographics and clinical information were extracted from the electronic medical record. Descriptive statistics and odds ratios (ORs) were calculated.

Of 171 patients with syphilis, 89 (52.0%) completed treatment. Patients ages 40-49 were least likely to complete treatment (OR 0.14; 95% CI 0.03-0.72, p = 0.02) compared to those ages 18-24. Non-heterosexual patients were significantly more likely to complete treatment (OR 3.60; 95% CI 1.13-11.49, p = 0.03) compared to heterosexual patients. Patients diagnosed in the emergency department completed treatment at the lowest rate.

A major gap in syphilis treatment still exists, which must be addressed to achieve optimal impact from syphilis screening programs.