Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016

Authors

Jennifer Richards, Florida Agricultural and Mechnical University, Institute of Public HealthFollow
James Matthias, STD and Viral Hepatitis Section, Florida Department of HealthFollow
Charlotte Baker, Department of Population Health Sciences, Virginia Polytech Institute and State UniversityFollow
Craig Wilson, STD and Viral Hepatitis Section, Florida Department of HealthFollow
Thomas A. Peterman, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and PreventionFollow
C Perry Brown, Institute of Public Health, Florida Agricultural and Mechanical UniversityFollow
Matthew T. Dutton, Florida Agricultural and Mechanical UniversityFollow
Yussif Dokurugu, Institute of Public Health, Florida Agricultural and Mechanical UniversityFollow

Publication Date

8-11-2019

Abstract

The Syphilis Health Check (SHC) had low estimated specificity (91.5%) in one Florida county. We investigated use of SHC by a range of Florida publicly-funded programs between 2015 and 2016 to estimate specificity, positive predictive value (PPV), field staff acceptance, and impacts on programmatic outcomes. All reported SHC results were extracted from routinely collected program data. Field staff were surveyed about SHC’s utility. Analyses investigated differences between SHC and traditional syphilis testing outcomes. Of 3,630 SHC results reported, 442 were reactive; 92 (20.8%) had prior diagnoses of syphilis; 7 (1.6%) had no further testing. Of the remaining 343; 158 (46.0%) were confirmed cases, 168 (49.0%) were considered false-positive, and 17 (5.0%) were not cases but not clearly false-positive. Estimated specificity of SHC was 95.0%. Overall, 48.5% of positives became confirmed cases (PPV). PPV varied according to prevalence of syphilis in populations tested. Staff (90%) thought SHC helped identify new cases but expressed concern regarding discordance between reactive SHC and lab-based testing. Programmatic outcomes assessment showed shorter time to treatment and increased numbers of partners tested for the SHC group; these enhanced outcomes may better mitigate the spread of syphilis compared to traditional syphilis testing alone, but more research is needed.

Recommended Citation

Richards, Jennifer; Matthias, James; Baker, Charlotte; Wilson, Craig; Peterman, Thomas A.; Brown, C Perry; Dutton, Matthew T.; and Dokurugu, Yussif (2019) "Evaluation of Rapid Syphilis Testing Using the Syphilis Health Check in Florida, 2015–2016," Florida Public Health Review: Vol. 16, Article 13.
Available at: https://digitalcommons.unf.edu/fphr/vol16/iss1/13