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Syphilis screening in jails reveals high infection rates, especially in females and African Americans. Jail-based treatment offers a crucial opportunity for intervention and preventing further spread of this STI.

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Area of Science:

  • Public Health
  • Epidemiology
  • Infectious Diseases

Background:

  • Syphilis cases have surged 80% in the US over 5 years, necessitating enhanced screening and treatment strategies, particularly in vulnerable populations.
  • Jails are critical settings for identifying and managing sexually transmitted infections (STIs) due to high-risk populations.
  • This study evaluated syphilis screening within a large urban county jail.

Purpose of the Study:

  • To determine the incidence of new syphilis infections in an urban jail.
  • To identify demographic groups disproportionately affected by syphilis.
  • To assess syphilis treatment completion rates among incarcerated individuals.

Main Methods:

  • Reviewed electronic health records of individuals with positive rapid plasma reagin (RPR) tests from April 2023 to March 2024.
  • Defined new syphilis cases based on RPR results (first positive, 4-fold titer increase, or conversion from negative).
  • Collected data on demographics, HIV coinfection, other STIs, and treatment completion; analyzed using chi-squared tests and SAS.

Main Results:

  • Out of 15,589 individuals tested, 11.6% had positive syphilis tests, with 5.2% newly diagnosed (815 individuals).
  • Newly diagnosed syphilis was higher in females (8.3%) and African Americans compared to other groups.
  • Treatment completion was 59.1%, with 17.4% released before treatment; doxycycline was the most common medication.

Conclusions:

  • Jail-based syphilis screening effectively identifies new infections and facilitates STI testing and treatment.
  • Females and African Americans represent key populations with higher syphilis burdens in this setting.
  • Efforts to increase syphilis screening, treatment, and prevention in correctional facilities are crucial for public health.