(PL16) A NOVEL APPROACH TO ADDRESSING THE SYPHILIS OUTBREAK IN LOS ANGELES COUNTY, CA: INTERVENTIONS IMPLEMENTED BY THE DEPARTMENT OF PUBLIC HEALTH'S CLINICAL FIELD TEAM

Background:
Since 2012, the syphilis and congenital syphilis epidemic among people of reproductive potential (PRP) in those assigned female sex at birth, aged 15-44 has continued to rise dramatically in Los Angeles County (LAC). Many of the syphilis cases among PRP experience housing instability, concurrent substance use, and mental health challenges, and are unable to access regular health care services.  In 2023, LAC Public Health (DPH) received a syphilis outbreak strategy grant to fund activities for syphilis control including the implementation of a novel clinical field team (CFT) consisting of two providers, a nurse, a community health worker and two management staff trained in the keen recognition and treatment of syphilis.

Methods:
The CFT began its work in December 2023 with regular test-and-treat events at various venues which serve the target population across LAC. Strategic advantages to this model include the capacity to incorporate real time syphilis record searches from DPH databases to inform our approach to rapid and lab-based testing and field treatment.

Results:
A preliminary analysis of 18 events conducted from December 6th through April 30th, 2024, shows that 254 participants were seen of whom 177 were screened for syphilis; 50% were female, 25% between the ages of 30 and 39 years, 39% identified as Latinx and 34% as Black. 123 had both rapid and lab-based syphilis reverse algorithm tests from which 20 early (primary, secondary and early latent), 13 late latent, and 7 new cases with no prior history were identified, 19 of whom were simultaneously treated in the field.

Conclusion:
Equipped with specialized public health resources, field testing, and provider-dispensed treatment, the CFT has successfully launched a multi-pronged approach to actively identify and treat previously untreated or new syphilis cases in unhoused and other PRP experiencing multiple challenges in accessing care, and loss to follow up.