Sola-Odeseye Zureyat, Kholy Jana, Culp Sophia, Harris Barry-Lewis, Nijhawan Ank E
From the University of Texas Southwestern Medical School.
Parkland Health, Correctional Health.
Sex Transm Dis. 2025 Sep 1;52(9):542-548. doi: 10.1097/OLQ.0000000000002178. Epub 2025 May 23.
Syphilis cases have increased by 80% in the United States in the past 5 years, demanding new approaches to screening and treatment, particularly among key populations. This study aimed to assess the impact of syphilis screening in a large urban county jail, determining rates of new syphilis infections, identifying demographic groups most affected by syphilis, and assessing treatment completion rates.
Electronic health records of individuals with positive rapid plasma reagin (RPR) results during incarceration in the Dallas County Jail between April 2023 and March 2024 were reviewed. New cases were defined by either a first positive RPR, a 4-fold titer increase, or a positive result after a previously negative RPR. Data on demographics, HIV coinfection, and recent chlamydia or gonorrhea infection were collected. Treatment medication and completion (no, partial, or full) were recorded. Comparisons of proportions were performed using χ2 analysis, and data analyses were conducted using SAS OnDemand for Academics (SAS 9.4 M8).
Of 15,589 individuals tested for syphilis, 12,607 (80.9%) were male and 2982 (19.1%) were female. Among these, there were 1816 (11.6%) cases of positive test results; 815 individuals (5.2%) were newly diagnosed with syphilis: 568 males (4.5%) and 247 females (8.3%). Among those newly diagnosed, most (71.2%) were treated with doxycycline. Overall, 482 individuals (59.1%) completed treatment, 191 (23.4%) received partial treatment, and 142 (17.4%) were released before receiving any treatment.
Syphilis screening in a large urban jail identified high rates of new infections and provided an opportunity for counseling, testing for other STIs and treatment. Females and African Americans had disproportionately high infection rates. Treatment completion was similar between doxycycline and intramuscular penicillin. Future studies should focus on increasing syphilis screening, treatment, and prevention in jails and other high-incidence settings.
在过去5年中，美国梅毒病例增加了80%，这就需要新的筛查和治疗方法，尤其是在重点人群中。本研究旨在评估在一个大型城市县监狱进行梅毒筛查的影响，确定新梅毒感染率，识别受梅毒影响最严重的人口群体，并评估治疗完成率。
回顾了2023年4月至2024年3月期间达拉斯县监狱关押期间快速血浆反应素环状卡片试验（RPR）结果呈阳性的个体的电子健康记录。新病例定义为首次RPR阳性、滴度升高4倍或之前RPR阴性后出现阳性结果。收集了人口统计学、HIV合并感染以及近期衣原体或淋病感染的数据。记录治疗药物和完成情况（未完成、部分完成或完全完成）。使用χ2分析进行比例比较，并使用SAS OnDemand for Academics（SAS 9.4 M8）进行数据分析。
在15589名接受梅毒检测的个体中，12607名（80.9%）为男性，2982名（19.1%）为女性。其中，检测结果呈阳性的有1816例（11.6%）；815名个体（5.2%）新诊断为梅毒：568名男性（4.5%）和247名女性（8.3%）。在新诊断的患者中，大多数（71.2%）接受了多西环素治疗。总体而言，482名个体（59.1%）完成了治疗，191名（23.4%）接受了部分治疗，142名（17.4%）在接受任何治疗前获释。
在一个大型城市监狱进行梅毒筛查发现新感染率很高，并为咨询、检测其他性传播感染和治疗提供了机会。女性和非裔美国人的感染率过高。多西环素和肌肉注射青霉素的治疗完成情况相似。未来的研究应侧重于在监狱和其他高发病环境中加强梅毒筛查、治疗和预防。
