Background Trends in congenital syphilis (CS) usually parallel those of primary and secondary (P&S) syphilis in women. Chicago has invested in a multi-pronged approach to address the syphilis epidemic in the city. Between 2010 and 2017, the total number of female P&S syphilis cases in Chicago decreased by 37% (from 87 to 55 cases) in parallel with a decrease in the number of CS cases (from 19 to 11). At the same time, national rates of CS increased 140%, from 9.7 per 100,000 live births in 2010, to a high of 23.3 per 100,000 live births in 2017.
Methods A retrospective analysis of surveillance data from 2010 through 2017 was performed on female cases of P&S syphilis (n=483) reported to the Chicago Department of Public Health.
Results Of 483 cases reported during this time, 382 (79.1%) were non-Hispanic black, 34 (7.0%) Hispanic, 27 (5.6%) non-Hispanic white, and 40 (8.3%) other or unknown ethnicity. Approximately 7% (32) of females were co-infected with HIV. The median age was 27 and did not change significantly over time, ranging from 24 to 32. Overall, 23% of interviewed females reported having sex while intoxicated with alcohol or drugs, and 15% reported having sex with anonymous partners. Only 6.2% of females diagnosed with P&S syphilis reported exchanging drugs for sex or money and <1% reported intravenous drug use or sex with partners using intravenous drugs.
Conclusion Our findings suggest that certain sexual behaviors, in particular anonymous sex and sex while intoxicated, are more frequently reported by women infected with syphilis. To curb the spread of CS further, there is a need to enhance surveillance and collect comprehensive behavioral risk factor data for females. Future interventions should focus on provider and public education, media campaigns targeted towards these sexual behaviors, and expansion of screening programs among females of reproductive age.
Disclosure No significant relationships.
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