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Background: Over the past decade, syphilis rates have increased among men who have sex with men (MSM) nationwide. Screening with a point-of-care, rapid treponemal syphilis test could improve syphilis control by facilitating same-day case identification and treatment.
Methods: From August 3rd, 2015 through October 26th, 2015, the New York City (NYC) Department of Health and Mental Hygiene offered syphilis screening using the Syphilis Health Check™ (SHC) on finger-stick specimens collected at a mobile unit in Chelsea, the NYC neighborhood with the highest primary and secondary syphilis incidence. The SHC was offered to asymptomatic persons aged >12 years who had no prior history of syphilis, and met any one of the following criteria: men who have sex with men (MSM); transgender females, transactional sex workers, or pregnant females. A real-time check of the NYC Syphilis & Reactor Registry was performed to verify each person’s syphilis history. The mobile unit offered no exams, only HIV and treponemal rapid tests for eligible persons, and referral to nearby care.
Results: A total of 57 persons were screened for syphilis using the SHC. Most (54/57) were MSM; median age was 35 years (range 22-69). Among those screened, 21% (12/57) had a positive SHC result. Eleven were linked to medical care for physical examination, confirmatory syphilis testing and management; among these 1 person was diagnosed with primary syphilis (positive RPR and FTA) and 10 had normal physical exams and negative RPRs. Of these 10 people, 7 (70%) had confirmatory treponemal testing and all were negative.
Conclusions: At least 58% of positive SHC tests were false positive. Further evaluation of the performance of the SHC on finger stick specimens is needed before this test is implemented for syphilis screening.