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Background: The Columbus Metropolitan Statistical Area is ranked 6th in the U.S. for rate of reported cases of primary and secondary syphilis. In Franklin County, Ohio—including the City of Columbus—the number of early syphilis cases (i.e., primary, secondary, and early latent syphilis) increased 150% between 2010 and 2015. It is estimated that nearly 20% of the total number of syphilis cases reported are “repeat cases.”
Methods: The Ohio Disease Reporting System (ODRS) was used to identify individuals that were diagnosed (i.e., new cases) with syphilis three or more times between 2010 and 2015. ODRS records, including detailed case notes, were reviewed. Data abstracted from the records included demographic, medical, and risk-related information. When available, viral load values were obtained from the Columbus Public Health (CPH) Ryan White program. Data were analyzed using Microsoft Excel (2010).
Results: A total of 33 individuals represented 102 new cases of syphilis between 2010 and 2015. Nearly all were identified as men who have sex with men (MSM) (n=30) and an overwhelming majority (n=27) were HIV-positive. Among the HIV-positive individuals, nearly all (n=25) reported having sex with someone infected with HIV. Additionally, 15 had reported viral loads and the majority of those (n=11) were virally suppressed. Alcohol use (n=27) and anonymous sex (n=26) were the most common risk factors reported by individuals, while an average of 6.5 sexual partners was reported per case. Most of the cases (n=75) were reported by CPH or HIV medical providers.
Conclusions: Individuals diagnosed with syphilis three or more times represent a unique and challenging population. HIV medical providers should consider screening all MSM patients every three months, even if the patient’s HIV is well controlled. In addition, CPH should work directly with HIV medical providers to develop targeted interventions for high risk HIV-positive MSM.