(P29) VARIATION IN SYPHILIS TREATMENT TIMELINESS BY DIAGNOSING FACILITY TYPE

Background:
Ensuring timely treatment for persons diagnosed with syphilis is critical to halting transmission and preventing adverse sequalae. To identify opportunities to reduce barriers to timely treatment, we investigated timeliness of syphilis treatment initiation using national syphilis data.

Methods:
We reviewed non-congenital syphilis case notifications provided to CDC through the National Notifiable Diseases Surveillance System during 2021‒2022. After excluding one state unable to transmit treatment date, we compared diagnosis date to the reported treatment date for all reported non-congenital syphilis cases to determine 1) the proportion of cases with documented treatment initiated and 2) the proportion with documented treatment initiated ≤30 days of diagnosis. We investigated if there were differences in treatment initiation by diagnosing facility type: STI/HIV-related, corrections, emergent care (ER, any hospital type, or urgent care), and specific-service (mental health, substance abuse facility, blood banks, laboratory).

Results:
Of the 372,131 syphilis case notifications included in the analysis, 86.8% had documented treatment and 77.7% had a treatment initiation date ≤30 days of diagnosis. Documentation of treatment was more frequent for cases diagnosed in STI/HIV-related facilities (92.7%; 50,323/54,275 cases) compared to correctional facilities (87.2%; 18,656/21,392 cases), emergent care facilities (86.2%; 52,244/60,612 cases), and specific-service facilities (76.9%; 17,496/22,765 cases). Treatment initiated ≤30 days of diagnosis was also more common in STI/HIV-related facilities (86.1%; 46,717/54,275 cases) compared to emergent care facilities (78.2%; 47,374/60,612 cases), correctional facilities (76.5%; 16,372/21,392 cases), and specific-service facilities (64.1%; 14,583/22,765 cases).

Conclusion:
Most patients diagnosed and reported with non-congenital syphilis had documented treatment initiated ≤30 days of diagnosis; however, patients diagnosed in service-specific facilities may face barriers to receiving timely treatment. To facilitate timely treatment, facilities could consider stocking syphilis-specific medications, updating policies to treat cases at time of service or ensure cases are linked to treatment, and improving coordination with local health departments to facilitate treatment.