Syphilis Partner Services – Case Finding for HIV and Other STDs

Background: Partner services (PS) have historically been regarded as an important control measure for syphilis. More recently, the utility of PS for syphilis cases has been called into question. Currently, PDPH offers PS for all early syphilis cases. Many contacts are referred to the STD clinics for evaluation and treatment. Clinic and interview data were reviewed to determine number of HIV, syphilis, gonorrhea and chlamydia infections identified through PS.

Methods: Individuals named as a sexual contact on a 2012 early syphilis case were extracted from the local database. Information collected about the patient and contact was systematically reviewed to ascertain the number of new infections detected from syphilis contact tracing. Summary data statistics were calculated.

Results: In 2012, 492/597 (82%) early syphilis cases received PS. Half of the original patients were HIV co-infected. 725 sexual contacts were elicited; of these, 456 were unique individuals with additional information including test results available in the database. 90% of contacts were male and among these were 81% MSM. Among the 456 individuals named and evaluated, 45 (9%) were new syphilis cases. In addition, 51 (10%) GC infections (23 rectal) and 32 (6%) Chlamydia infections were detected. Among the contacts 177, (36%) were previously diagnosed with HIV. Of the 316 not previously diagnosed with HIV, 8 (2.5%) new infections were detected. Finally, 30 (6%) contacts to syphilis had multiple new infections diagnosed upon exam for their syphilis exposure.

Conclusions: While the utility of contact tracing for syphilis has been called into question, in 2012 PS for syphilis in Philadelphia led to the identification of 23 rectal GC and 8 new HIV infections. As these patients are contacts of early syphilis, they are clearly in a high risk sexual network, and early identification may lead to decrease in subsequent HIV and syphilis transmission.