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. 2024 Aug 1;51(8):516-520.
doi: 10.1097/OLQ.0000000000001980. Epub 2024 Apr 17.

Opt-Out Syphilis Screening at an Urgent Care Center in Atlanta: Evaluation of a Pilot Program

Stephanie Sweitzer, Joseph Sharp, Dylan Baker  1 , Alexis Lynch  2 , Meredith A Stauch  2 , Matthew Wheatley  2 , Meredith Lora  1 , Valeria D Cantos  3 , Judah Gruen
Affiliations

Opt-Out Syphilis Screening at an Urgent Care Center in Atlanta: Evaluation of a Pilot Program

Stephanie Sweitzer et al. Sex Transm Dis. .

Abstract

Background: Human immunodeficiency virus (HIV) and syphilis disproportionately impact communities with low access to primary care, who often utilize urgent care centers (UCCs) for sexual health care. UCC visits represent an opportunity for identification and treatment of syphilis and linkage to HIV testing and prevention services. We describe a universal, opt-out syphilis screening program pilot at an Atlanta UCC.

Methods: A chart review was performed on patients 18 years and older who were offered opt-out syphilis screening and had a rapid plasma reagin (RPR) test collected from September 1, 2021 to December 31, 2021. Demographic data, syphilis stage and treatment, and HIV testing and serostatus were abstracted from the electronic health record. Patients with reactive RPRs were contacted by a study physician for syphilis staging and treatment, counseling, and referral for HIV preexposure prophylaxis (PrEP) or treatment.

Results: From September 1, 2021 to December 31, 2021, 5794 patients were triaged and 1381 underwent RPR screening (23.8%). Eighty (5.8%) had reactive RPRs, and 42 (52.5%) had active syphilis. Of those with active syphilis, 39 (92.9%) received any treatment, and 35 (83.3%) completed treatment. Patients with late syphilis were less likely to complete syphilis treatment (adjusted odds ratio, 0.03; P = 0.009; 95% confidence interval, 0.002-0.42). Among 955 offered PrEP, 41 (4.3%) expressed interest in PrEP, and 7 (0.7%) completed PrEP clinic intake. Univariate analysis did not identify any factors associated with interest in PrEP.

Conclusions: In a UCC setting, routine, opt-out syphilis testing resulted in increased syphilis identification and treatment. It also provided an opportunity for PrEP counseling and referral, although few patients completed PrEP clinic intake.

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Conflict of interest statement

Conflict of Interest and Sources of Funding: The authors report no financial or nonfinancial conflicts of interest. Some of the material in this manuscript has been previously presented as an abstract at the Infectious Disease Week (ID Week) 2023 conference. This work was supported by internal departmental funding.

References

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