(P85) THE NECESSITY AND FEASIBILITY OF OPT-OUT SYPHILIS TESTING OF FEMALES IN LOCAL JAILS

Background:
During 2018-2022, primary and secondary (P&S) syphilis rates increased by 65.4%, nationwide. P&S syphilis rates in Florida increased by 54% (17th in the US). In 2022, Florida reported 127.6 congenital syphilis cases per 100,000 live births and 82.1 total syphilis cases per 100,000 females aged 15-44 years.

CDC’s data highlights that most syphilis cases are found outside of STD clinics, suggesting the need for testing and treatment in non-traditional settings (e.g., correctional facilities). The U.S. Bureau of Justice Statistics shows that the number of women in prisons is over 90,000 and increased by 9% from 2021 to 2022. Thus, expanded syphilis testing in correctional facilities may help decrease syphilis transmission. NACCHO funded three local health departments to assess the feasibility and effectiveness of routine, opt-out syphilis screening of females and other individuals of childbearing capacity in local jails. Screening and treatment outcomes from Orange County Corrections - Health Services Department (OCC-HS) were analyzed.

Methods:
From April 2023-January 2024, OCC-HS collected monthly quantitative data on the number of women booked, number tested for syphilis within 48 hours of booking, new case identification, and treatment outcomes. Monthly qualitative reports also captured progress and challenges and were thematically assessed.

Results:
Over ten months, 6,344 females were booked, and 472 (7.4% of bookings) were tested for syphilis (130 within 2 days of booking). There were 11 confirmed positive tests resulting in a 1.4% (6/472) new syphilis case rate. Of those confirmed positive tests, 90% were treated (n=10) and 54.5% were new cases (n=6).

Conclusion:
OCC-HS experienced challenges, including staff shortages, delays in confirmatory testing and results, and inmate refusals. Despite this, the percentage of positive cases and the high mobility of this population between the community and jail demonstrates that syphilis screening in jails could help address syphilis and congenital syphilis prevalence nationwide.