title: Substance abuse and syphilis in urban adolescents: a new risk factor for an old disease.
abstract: The incidence of syphilis is increasing. To identify the epidemiologic characteristics of adolescents with syphilis in an urban adolescent clinic, we performed a retrospective review and case-control study of 59 patients with syphilis and 111 sex-matched controls seen at our institution between 1985 and 1988. Only 24% of cases occurred in males, in contrast with 61% in a 1977-1981 study. Almost one-half (46%) of cases occurred in asymptomatic individuals, and only 24% were diagnosed at the initial visit. Patients with syphilis were more likely to have a history of substance abuse (odds ratio, 4.94; 95% confidence interval, 1.83, 13.3). This study suggests that the epidemiology of syphilis in adolescents may be changing. The high percentage of asymptomatic syphilis cases underscores the need for a high index of suspicion, particularly in sexually active adolescents who abuse drugs.
authors.affiliation: Department of Pediatrics, Georgetown University Children's Medical Center, Washington D.C. 20007.
authors.forename: J M
authors.initials: JM
authors.lastname: Cox
authors.forename: L J
authors.initials: LJ
authors.lastname: D'Angelo
authors.forename: T J
authors.initials: TJ
authors.lastname: Silber
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications*; D013587:Syphilis / Q000150:complications*; D014504:Urban Health