(P86) OPT-OUT POPULATION-BASED SYPHILIS SCREENING IN LOUISIANA PARISH JAILS

Background:
Louisiana had the 9th highest primary/secondary syphilis rate in 2022 and has consistently had the highest incarceration rate in the United States. Beginning in December 2021, the Louisiana Department of Health (LDH) and the Department of Corrections (DOC) collaborated on a population-based opt-out screening program for syphilis, hepatitis C and HIV in Louisiana’s parish jails. A mobile phlebotomy team conducted the screenings and referred all people with positive results to medical staff for treatment.

Methods:
This analysis includes syphilis results from December 2021 through February 2024. Lab results were exported from an online laboratory portal, and demographic information was obtained from the DOC registration system. People diagnosed with syphilis were matched to the LDH STI Surveillance database to determine syphilis stage and treatment status.

Results:
Screening is complete at 32 parish jails within 29 parishes. Of the 3,997 people screened, 213 (5.3%) had a reactive RPR, and 64 people were confirmed to be new syphilis cases. Two cases were primary, 3 were secondary, and 59 were late/unknown duration. The majority (84%) were appropriately treated. Of the new cases, 81% were male and 52% were black. Of those with a reactive RPR, 83 were previously treated, 20 were confirmed not to have syphilis, and 46 were administrative closures or not located.

Conclusion:
Employing a mobile phlebotomy team is an effective model for opt-out population-based screening in local jails. However, disease intervention specialists had some difficulty interviewing positive cases, staging cases, and confirming treatment. Given the large number of new cases identified, syphilis screening at jail intake is recommended.