Role of Safety Net Providers in Chicago, IL: Expansion of Syphilis and Extra-Genital Gonorrhea Screening Among Men Who Have Sex with Men

Background:  Chicago, like most other large urban areas, has high rates of sexually transmitted diseases (STD). While the burden of STDs is greater in Chicago, the populations most impacted are Men who have sex with Men (MSM). In 2015, Howard Brown Health Center (HBHC) was awarded Safety Net funds to expand syphilis and extagenital gonorrhea (GC) screening among MSM.

Methods: Data were extracted from Electronic Medical records (EMR) and surveillance system and were analyzed using SAS version 9.3. 

Results:  Syphilis Screening: In total, 17,718 syphilis tests were performed across all programs in 2015 of which 73% (13,022) were performed in MSM. Overall, syphilis screening increased by 34% (from 13,170 in 2014 to 17,718 in 2015).  Through expanded screening, 5.1% (141/2,789) of new syphilis cases were identified in Hispanic MSM (median age=30 years old) and 7.1% (158/2,216) among African American (AA) MSM (median age= 28 years old). Approximately 55% of AA MSM and 42% of Hispanic MSM tested positive for syphilis were co-infected with HIV. In 2015, 664 syphilis cases were referred for partner services (PS) and 92% (609/669) of new syphilis cases were interviewed.  Rectal GC Screening: During the same time period, rectal GC screening increased by 102% (from 3,690 to 7,446 in 2015), with an increase by 105% among AA MSM and 104% among Hispanic MSM.  Overall prevalence for AA MSM was 13% and 10% Hispanic MSM. Among individuals that tested positive for rectal GC, 52% of AA MSM and 42% of Hispanic MSM were also co-infected with HIV. In 2015, out of 25 rectal GC cases referred to PS, 96% (24) of them were interviewed. 

Conclusions: Our findings demonstrate the importance of collaboration between community based health centers and health departments. Ongoing assessment of screening practices for syphilis and extra-genital infections among MSM is important for interrupting transmission of STDs and HIV.