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Background: In 2014, Louisiana ranked 2nd in the nation for primary and secondary syphilis case rates. In order to reduce these rates, the Louisiana Office of Public Health (OPH) implemented rapid syphilis testing (Syphilis Health Check) in CBOs that have clinical wellness centers that provide HIV and STD screening services for men who have sex with men and transgender clients. The CBOs also offered rapid syphilis testing at their main office, which had historically only offered HIV screening. The goal was to provide rapid syphilis testing for hard to reach populations who might not otherwise get tested with traditional lab based screening.
Methods: Training was provided to three pilot sites in October 2015 and extended to three additional sites in January 2016 across Louisiana. All of the wellness centers are connected to CBOs, so training was provided to both clinical and non-clinical staff to increase the total number of tests provided. Data were collected on an HIV/STD screening form that is sent to OPH weekly.
Results: From October 2015 - February 2016, 1,234 rapid tests were conducted, 54 results were positive and 30 were confirmed positive. Of the confirmed cases, 20 were new syphilis diagnoses and 10 had been previously diagnosed and treated. There was a learning curve at some sites for testers who had not traditionally conducted syphilis testing, especially those without a clinical background. Some challenges included ensuring the testers properly asked pre-screening questions, accurately interpreted the results and ordered the correct follow-up tests. Retraining individuals in person, adding additional detail to the protocol, and conference calls with agencies improved efficiency and reduced human error.
Conclusions: Overall, the pilot implementation of rapid syphilis testing was successful and identified 20 new syphilis cases. With ongoing technical assistance, rapid syphilis testing increases screening for clients who might not otherwise get tested.