Description
Syphilis rates have dramatically increased in San Diego from 2003 to 2009. Eightyfour percent of the 265 cases in San Diego were among men-having-sex with men (MSM). Due to the rising rates, the San Diego County Health Department partnered with the Family Health Centers of San Diego to implement a syphilis symptom recognition campaign known as ?Sore Loser? which targeted the MSM community. This campaign hopes to increase the proportion of diagnoses of primary and secondary (symptomatic) syphilis versus early latent syphilis (asymptomatic). Further, it sought to decrease the time from onset of symptoms to getting tested, diagnosed, and treated. The campaign began in June 2009 and officially terminated in August 2009. It raised awareness through print media, billboards, and outreach cards that were mainly focused within three zip codes. The evaluation is conducted from data routinely collected from the county for syphilis surveillance. Main outcome variables include proportion of those being tested with symptomatic syphilis and the time to diagnosis and testing after onset of symptoms. Variables included are prior knowledge of HIV status before syphilis test, current HIV result, having syphilis symptoms, age, race, and time from first date of onset of syphilis symptoms to first exam date. A Cochran-Armitage analysis, Chi-square analysis, Kaplan-Meier survival curve and a Cox Proportional Hazard model were used to analyze the data. Of the 483 of MSM who tested positive, 329 (68.12%) were symptomatic at the time of examination and 154 (31.88%) were not. Pre-campaign 303 (62.73%) were diagnosed with syphilis while during/post campaign 180 (37.27%) were diagnosed with syphilis. After adjusting for all other variables, those with symptomatic syphilis were 1.45 (95% CI: 0.94, 2.23) times more likely to have been diagnosed with symptomatic syphilis post-campaign compared to pre-campaign. A Kaplan-Meyer Analysis was used to determine if the time of diagnosis for number of cases decreased post campaign compared with pre campaign. There was no significant association between time to diagnosis and exposure to the campaign. Although our results did not reach statistical significance, preventive measures such as this campaign, may be effective in emphasizing early detection and treatment, promoting safe sex practices, and inhibiting the increasing incidence of syphilis among MSM.
