Epidemiologist Arizona Department of Health Services
Background: Since 2018, Arizona has experienced an increase in reported cases of syphilis. In 2022, Arizona reported the sixth-highest rate of primary and secondary (P&S) syphilis in the United States. Given the increased burden of syphilis and knowledge of associated risk factors, we examined substance use trends among reported P&S syphilis cases to determine which demographic populations are most affected and how substance use has changed over time.
Methods: Primary and secondary syphilis cases were identified using Arizona’s STI surveillance database, Patient Reporting Investigation Surveillance Manager (PRISM). Drug risk factors and demographic information captured in PRISM were analyzed among P&S syphilis cases reported in persons aged greater than 15 years old from January 1, 2018 to December 31, 2022
Results: Between 2018 and 2022, Arizona reported 7,922 P&S syphilis cases. Among these P&S syphilis cases, 79.6% (n=6,306) had complete drug risk information, with 22.5% (n=1,422) reporting substance use. In 2022, substance use was most commonly reported among males (n=268, 16.9%), persons aged 35 to 44 years old (n=136, 8.6%), and non-Hispanic white persons (n=136, 8.6%). From 2018 to 2022, there was an increase in reported use of crack (0.2% to 1.1%), cocaine (3.5% to 5.0%), and methamphetamines (16.2% to 20.6%), while a decrease was seen in reported use of heroin (3.3% to 2.3%) and intravenous drugs (4.8% to 4.1%).
Conclusion: Primary and secondary syphilis continues to be a public health concern in Arizona. The increased prevalence of substance use among Arizona’s P&S syphilis cases indicates persons who report substance use should continue to be prioritized for testing, treatment, and other prevention services.
.png)
