March 19, 2012
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Syphilis testing rates increased among adolescents

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Syphilis testing rates in adolescent populations increased during a recent 3-year period, according to findings presented at the Society for Adolescent Health and Medicine 2012 Annual Meeting.

Researchers from a large urban primary care adolescent clinic in Cincinnati examined syphilis testing practices and disease incidence with the aim of exploring gender differences. They retrospectively reviewed health records for patients aged 13 to 22 years who had visited the clinic from 2006 to 2009.

Eligible participants had a history of Chlamydia trachomatis testing at the visit. This test was used as a proxy indication of sexual activity.

Age, sex, race and year were taken into consideration for analysis for two outcome measures: completed syphilis testing and positive syphilis test.

The final analysis included 18,777 patient visits. Females accounted for 86% of those visits, and 75% of those visits were made by patients self-reporting as black.

The mean age at the time of visit was 17.2 years (standard deviation of 1.9).

Syphilis testing was performed at 13% of visits among females and 29% of visits among males (P<.01). An increase in the rate of testing for visits among females was observed from 2006 to 2009, 5% vs. 21.9% (P<.01). A similar increase was observed among males, from 16.2% to 44.9% (P<.001).

From 2006 to 2007, the syphilis testing rate increased from 5% to 11% among females (P<.01) and from 16.2% to 25.9% among males (P<.01). From 2008 to 2009, syphilis testing rates increased from 11.9% to 21.9% among females (P<.01) and from 27.5% to 44.9% among males (P<.01).

No significant difference in testing was observed from 2007 to 2008 among both sexes.
Positive syphilis testing indicating infection was 1% among females and 0.5% among males, resulting in a ratio of male-to-female syphilis infection of 1:2.

From 2006 to 2009, the rate of syphilis infection demonstrated a nonsignificant change from 0% to 1.4% for female visits and from 1% to 0.7% for male visits.

“Although clinicians appear to have increased their screening practices over time, which may reflect changes in HIV screening recommendations and local epidemiology, there was no significant increase in rates of syphilis diagnoses,” the researchers wrote. “These findings contradict local public health data for adolescents and warrant further investigation.”

Disclosure: The researchers report receiving fellowship funds.

For more information:

  • Patterson-Rose SA. Poster #1. Presented at: the Society for Adolescent Health and Medicine 2012 Annual Meeting; March 14-17, 2012; New Orleans.