Background:
Some evidence suggests that contact tracing (locating, interviewing, and treatment of sex partners of persons with sexually transmitted disease) may be less effective in populations with anonymous/casual sex partners, such as male syphilis patients who report sex with men.

Objective:
To compare contact tracing outcomes among 2003 Fulton County male syphilis patients reporting sex with men (MSM) or with women only (MSWO).

Method:
We reviewed 547 2003 health department records of early (primary, secondary, or early latent) syphilis cases. Data on patient characteristics from the national syphilis case report form (73.54), an interview form used in Fulton County, and contact tracing records were evaluated for demographics, provider and disease characteristics, and sexual behaviors. To assess outcomes of contact tracing, we compared the numbers per case of contacts investigated, located, and diagnosed with syphilis by sexual behavior category and evaluated these findings using the Wilcoxon rank sum or chi-square tests as appropriate.

Result:
After exclusion of cases without interview data, 401 (73%) cases remained; among these, 243 (61%) reported MSM behavior and 158 (39%) did not. Interviews of MSM index patients resulted in higher mean numbers of contacts named (0.80 vs. 0.72, p=0.04) and located (0.65 vs. 0.57, p=0.01) per case than interviews of MSWO index patients. There were no significant differences in the mean number of contacts of MSM and MSWO index patients diagnosed with syphilis per case (0.22 vs. 0.24, p=0.46). The mean number of unnamed sex partners per case was slightly higher for MSM (3.1) than MSWO (2.5) index patients (p=0.39).

Conclusion:
Our study comparing case finding by the same health department personnel demonstrates that outcomes of contact tracing in a large city in the southern U.S. are similar for MSM and MSWO.

Implications:
This analysis supports continued efforts to perform contact tracing activities among MSM as well as MSWO syphilis index patients.