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Community syphilis testing in South Dakota found a 5.3% prevalence of undiagnosed infections. Incentives increased access to vital screening and treatment for American Indian/Alaska Native populations.

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Community Health Interventions

Background:

  • Syphilis rates are alarmingly high and increasing among American Indian/Alaska Native (AI/AN) communities, especially affecting women and infants.
  • Urgent interventions are needed to provide syphilis testing and timely treatment to sexually active AI/AN populations.

Purpose of the Study:

  • To implement and evaluate a community-based syphilis screening program in Rapid City, South Dakota.
  • To assess the prevalence of undiagnosed syphilis and the effectiveness of incentives in a target population.

Main Methods:

  • A partnership between the Great Plains Tribal Epidemiology Center and a local healthcare facility offered free community-based syphilis, HIV, and HCV testing from December 2022 to June 2024.
  • Participants received cash incentives for undergoing testing.
  • Fifteen testing events were conducted, with 1434 unique individuals tested.

Main Results:

  • A syphilis prevalence of 5.3% (76/1434) was identified among previously undiagnosed individuals, with 67.1% being female.
  • Treatment was provided to 80.3% of those diagnosed with syphilis within an average of 36 days.
  • The cost per test was $88, and the cost to identify a new case was $2,079.

Conclusions:

  • Community-based screening effectively identified a high prevalence of undiagnosed syphilis.
  • Incentives played a crucial role in encouraging community member participation in screening services.
  • Collaborative, community-centered approaches are beneficial for syphilis diagnosis and treatment but require sustained resources.