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The Footprint of Old Syphilis: Using a Reverse Screening Algorithm for Syphilis Testing in a US Geographic Information Systems–Based Community Outreach Program

Goswami, Neela D. MD, MPH*; Stout, Jason E. MD, MHS*; Miller, William C. MD, PhD; Hecker, Emily J. RN, MSN*; Cox, Gary M. MD*; Norton, Brianna L. MD, MPH*; Sena, Arlene C. MD

doi: 10.1097/OLQ.0000000000000025

The impact of syphilis reverse sequence screening has not been evaluated in community outreach. Using reverse sequence screening in neighborhoods identified with geographic information systems, we found that among 239 participants, 45 (19%) were seropositive. Of these, 3 (7%) had untreated syphilis, 33 (73%) had previously treated syphilis infection, and 9 (20%) had negative nontreponemal test results.

Implementing the reverse screening algorithm for syphilis testing in a community-based outreach program identified 19% seropositivity and 7% untreated syphilis, as well as a high prevalence of previously treated syphilis infection.

From the *Department of Medicine, Duke University Medical Center, Durham, NC; and †Department of Medicine, University of North Carolina, Chapel Hill, NC

Acknowledgments: The authors thank Muhammad L. Mackalo and Darvlyn Mclean of the North Carolina Department of Health, Carter Vickery of Wake County Community Services; Yvonne Torres, Carla Piedrahita, and Debbie Turner of Wake County Human Services; and the following Duke faculty, staff, and students who assisted with the community screenings: David Holland, Susanna Naggie, Marshall Ahearn, Sujit Suchindran, and Paul Park. This work was supported by National Institute of Health (NIH) T32 AIDS Training Grant (5T32-AI007392-22, to N.D.G.) and a developmental grant from the Duke Center for AIDS Research, an NIH-funded program (P30A164518, to J.E.S.).

Conflicts of interest and source of funding: The authors have no conflicts of interests to declare.

Correspondence: Neela D. Goswami, MD, MPH, is to be contacted at Department of Medicine, Duke University Medical Center, DUMC 102359, Durham, NC 27707. E-mail:

Received for publication April 10, 2013, and accepted June 25, 2013.

© Copyright 2013 American Sexually Transmitted Diseases Association