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Background: Howard Brown Health Center (HBHC) identifies a substantial proportion of syphilis cases in Chicago. During 2009 HBHC Disease Intervention Specialists (DIS) reported an increase in new cases of syphilis among young, transgender women.
Objectives: To determine if new syphilis cases among transgender women at HBHC are statistically different from historical trends and to describe the demographics and associated risk factors of the cohort of cases.
Methods: Data from clinic-based sentinel surveillance systems were used to assess statistical changes in case rates. Case reports provided descriptive and risk behavior data.
Results: An increase in the rate of syphilis diagnoses among transgender women occurred between 2005 and 2009, from 1.3% in 2005-2008 to 10.1% in 2009 (p<0.01). Between 2005 and 2008, 151 syphilis tests yielded two new cases. In 2009, 89 tests yielded nine new syphilis cases among eight transgender women; one client was re-infected during this period. Of the nine cases, one (11%) was primary, four (44%) were secondary, two (22%) were early latent, two (22%) were late latent and latent of unknown duration syphilis. Median age was 22 years (range 19-24) and the majority (66%) were non-Hispanic black. All (100%) were HIV-positive; six (75%) met partners on phone chat lines; six (75%) were transiently housed; five (63%) were incarcerated within the past year; and four (50%) acknowledged exchanging sex for money. No common sex partners were named during case investigation interviews.
Conclusions: These data indicate that syphilis is an emerging concern among young, transgender women in Chicago. Community outreach efforts, including medical provider awareness, should focus on reaching this at-risk population.
Implications for Programs, Policy, and/or Research: Enhanced screening and targeted prevention messages are needed for transgender women in Chicago to address the syphilis increases in this population.