Background: In 2012, to streamline STD partner service activities in NYC and target limited resources, the New York City Department of Health and Mental Hygiene’s (DOHMH) Bureau of STD Control (BSTDC) conducted an evaluation of syphilis interview outcomes. Syphilis case data were analyzed by disease stage, and select demographics of the index case-patient to examine variances in outcomes among specific populations. Subsequently, in July 2012, BSTDC changed syphilis interview criteria, restricting early syphilis interviews to those ≤ 45 years of age and ceasing interviews of both males and females with late latent or latent of unknown duration syphilis.
Methods: Using STD registry data, we compared early syphilis partner indices and time to interview data from 2011 to the year after the changes were implemented (7/23/12 – 7/22/13). Chi-square was used to compare these outcomes before and after the interview criteria change.
Results: The changes in interview criteria resulted in a decrease in overall syphilis interviews (2041 vs. 1866). The partner index (PI) remained unchanged for Primary and Secondary (P&S) syphilis (0.95 vs. 0.92), but increased slightly for Early Latent (EL) syphilis (0.71 vs. 0.76, NS). After the criteria change, P&S and EL syphilis cases were more likely to be interviewed within 14 days of specimen collection (48% vs. 61%, p=<0.001 and 42% vs. 56%, p=<0.001 respectively), and the disease intervention index for all syphilis cases increased (0.23 vs. 0.26, p=0.03).
Conclusions: Narrowing the interview criteria for syphilis cases did not yield additional partners per case, but the number of partners with favorable dispositions including those treated for syphilis exposure and/or infection increased and we improved timeliness to interview among priority cases. Optimization of partner services will continue to be necessary as demands on case investigation and partner services staff increase and resources diminish.