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Updated: Sep 3, 2026

An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
Not so fast, I am serofast: Using actionable patient education to drive appropriate management of people with
Dennis Kan1,2, Molly Stenzel2, Julie Thompson1
1Duke University School of Nursing, Durham, North Carolina.
Background:
An increase in syphilis cases in the United States and the global shortage of Benzathine Penicillin G (BPG) calls for evidence-based optimization. Confusing serologies and incomplete sexual history exacerbate the overprescription of BPG, especially for patients with "serofast" serologies.
Purpose:
The aim of this project was to reduce unindicated BPG administration while maintaining or improving appropriate BPG administration in people diagnosed with syphilis.
Methodology:
A longitudinal pre-post design was implemented where actionable education was delivered to patients who received BPG injection to treat syphilis.
Results:
Benzathine Penicillin G was administered 187 times (69 preintervention, 118 postintervention), and inappropriate administration declined by 7.9% relatively (10.1-9.3%). There was no difference in outcomes between the newly infected and reinfected patients.
Conclusion:
This project demonstrated modest improvements in the administration of appropriate BPG, although the results did not reach statistical significance.
Implications:
Future interventions should focus on automating patient education within the electronic health record. The growing prevalence of syphilis among non-traditional risk groups emphasizes the importance of sexual health screening and educational approaches to enable patients to advocate for appropriate syphilis management, especially when they are serofast.
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