Missed and Delayed Syphilis Treatment and Partner Elicitation: A Comparison Between STD Clinic and Non-STD Clinic Patients

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Abstract
Background: Because of increases in reported syphilis, we sought to identify factors associated with missed and delayed syphilis treatment and partner elicitation interview. Methods: We reviewed syphilis cases reported during June 1, 2006 to May 31, 2007 and conducted multivariate logistic regression analyses to determine demographic and clinical predictors of missed and delayed syphilis treatment and partner elicitation interview. Results: Of 638 syphilis cases, 38 (6%) were identified as untreated cases. Median time-to-treatment was 7 days (range: 0-380) and median time-to-partner elicitation interview was 14 days (range: 0-380 days) for all case-patients. Both intervals were shorter for patients among whom syphilis was diagnosed at the STD clinic versus non-STD facilities. In multivariate analysis, diagnosis at a non-STD clinic (AOR: 2.6; 95% CI, 1.0-6.9) and having a late infection of unknown duration (AOR: 2.1; 95% CI, 1.0-4.6) were significantly associated with untreated syphilis. Conclusion: Time-to-treatment and time-to-partner elicitation interview were shorter for patients among whom syphilis was diagnosed at the STD clinic. For non-STD settings in Maricopa County, improvements in quality of care (i.e., timely treatment) and expeditious public health interventions (i.e., partner elicitation interview) are needed.