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Background: Increases in women with syphilis have occurred in Maricopa County (Phoenix Area) during 2012-2014. Case interview and partners services outcomes related to female syphilis case investigation should be optimized to prevent congenital syphilis.
Methods: To describe the findings of case investigations and partner services related to female syphilis, Arizona PRISM STD surveillance records for female syphilis cases and linked partners were reviewed for the period January 1, 2013 through December 31, 2014.
Results: During 2013-2014, 319 female syphilis cases were reported for Maricopa County. Median age was 31 years (range 15-85); 128 (40%) were Hispanic, 78 (25%) White, 42 (13%) Black, and 23 (7%) American Indian. There were 11 (3%) cases diagnosed in primary stage, 50 (16%) secondary, 52 (16%) early latent, and 206 (65%) late latent; 77 (24%) of women were pregnant at the time of syphilis diagnosis, 44 (14 %) had unknown pregnancy status. Methamphetamine use was reported by 57 (18%) and 51 (16%) reported incarceration within the previous 12 months; 121 (38%) reported history of STD diagnosis; 47 (15%) reported sex with anonymous partners. Private providers, inclusive of OB/GYN specialty, diagnosed 97 (30%) of cases, 50 (16%) were diagnosed in corrections, and 48 (15%) were diagnosed by the Maricopa County STD Clinic. Interviews were completed for 297 (93%) of the 319 cases; 273 male contacts were investigated (average 0.92 contacts/interviewed case). Of investigated contacts, 72 (26%) received preventive treatment, 43 (16%) were infected and treated for syphilis, 55 (20%) were unable to be located, 27 (10%) were not infected, and 1 (8%) were previously treated for the infection.
Conclusions: Female syphilis case investigations indicate high risk behaviors among cases and difficulty in locating partners for treatment. Approaches that improve investigations could avert congenital syphilis by assuring treatment of infected women and their contacts.