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Background: CDC recommends that MSM diagnosed with early syphilis receive a follow-up test at a minimum of 6 and 12 months to ensure adequate treatment response.
Objectives: We assessed the proportion of patients meeting the CDC guidelines for follow-up testing after an initial diagnosis of early syphilis.
Methods: Data were collected as part of routine STD surveillance and analyzed using SAS version 9.1.
Results: Of 4,693 syphilis tests performed from January 2002 through December 2007, 210 (4.5%) cases of early syphilis were detected among 187 MSM in primary care. After the initial diagnosis, 102/187 (54.5%) had an eligible visit in < 6 months; 125/187 (66.8%) had an eligible visit within 1 year. 66/102 (64.7%) of men with an eligible visit < 6 months had a follow-up test for syphilis at that visit. 104/125 (83.2%) of those with an eligible visit within 1 year were tested. The median time between initial diagnosis and next test was 6.1 months (95% CI 5.0-7.2 months). HIV positive men and those with prior STD history were more likely to be retested for syphilis within 1 year; age and race/ethnicity were not associated with retesting.
Conclusions: Just over half of clients returned to the clinic within 6 months of initial diagnosis and a third of those were not retested. STD history and HIV infection were associated with increased likelihood of timely re-screening, suggesting that the importance of re-screening may not be emphasized among men without traditional risks.
Implications for Programs, Policy, and/or Research: The extent to which CDC recommendations are met depends on whether the patient returns to the clinic in a timely manner and whether they are tested at the follow-up visit. The importance of follow-up screening for syphilis should be emphasized for both clinicians and clients.