(P28) TREATMENT INDICES AMONG INCARCERATED AND RECENTLY INCARCERATED PEOPLE WITH SYPHILIS IN MARICOPA COUNTY, 2016-2022

Background:
During 2016-2022, Maricopa County, Arizona experienced a 50% average annual increase in the number of syphilis cases diagnosed in correctional facilities and an 18.5% increase in the number of syphilis cases reporting incarceration in the previous 12 months.

Methods:
The Arizona STD surveillance database (PRISM) was used to characterize testing, demographic, and treatment data from syphilis cases reported during 2016-2022. Excluding patients treated prior to receiving a lab result, time to treatment was calculated as median days elapsed between initial lab result date and initial treatment date.

Results:
During 2016-2022, 19,596 total cases of syphilis were reported in Maricopa County: 13.6% (2,670/19,596) diagnosed in a correctional facility; mean age 33 years; and 61.6% (1,646/2,670) men.  Additionally, 14.8% (2,909/19,596) were diagnosed outside of corrections but self-reported a history of incarceration in the last 12 months; mean age 32 years; 61.7% (840/1,361) men. 

Of cases diagnosed within correctional facilities, 20.5% (548/2,670) had no reported syphilis treatment compared to 6.3% (86/1,362) of cases reporting incarceration in the last 12 months and 7.8% (1,209/15,563) of all remaining syphilis cases. 

Median time to treatment among cases diagnosed in a correctional facility was 7 days (range: 0-477 days), and 8 days (range: 0-367 days) for patients incarcerated in the last 12 months.

Among treated patients diagnosed in a correctional facility, 93.2% (1,978/2,122) were treated at a correctional facility, and 4.4% (94/2,122) at the public STD clinic. In comparison, the public STD clinic (54.2%, 691/1,276) and hospitals (13.0%, 166/1,276) were the most common treatment site types for patients with recent incarceration.

Conclusion:
Nearly one third of persons with syphilis in Maricopa County were diagnosed in correctional facilities or reported incarceration within 12 months prior to diagnosis.  Lack of treatment and treatment delays indicate opportunities for rapid syphilis diagnosis and treatment within correctional systems.