Syphilis serologic prevalence monitoring among STD clinic clients: correlation with reported syphilis incidence, San Diego, CA, 1985-2004.
OBJECTIVE
To describe the serologic test for syphilis (STS) prevalence among STD clinic clients, determine the correlation between STS prevalence trends and reported community-diagnosed primary and secondary (P&S) case incidence, and evaluate the usefulness of STS prevalence monitoring as a component of syphilis surveillance.


METHODS
During the period 1985-2004, 21,4336 STS were done among STD clinic clients and a variety of STS prevalence measures were evaluated.


RESULTS
From 1985-1991, 10.2% of STS were positive, which declined to 5.6% during 1992-2004. Overall, STS positivity (>or=1:8) and male positivity (>or=1:8) trends were correlated with reported community-diagnosed P&S case incidence and case incidence in men (r = 0.58 and r = 0.81, respectively). Male STS positivity (>or=1:8) began increasing in 2001, 1 year before the increase in syphilis incidence in men, which began in the latter half of 2002 and occurred mostly among men who have sex with men.


CONCLUSIONS
In a syphilis outbreak in men who have sex with men, STS prevalence (>or=1:8) among male STD clinic clients was a useful measure of syphilis case incidence trends and may provide an early warning for a subsequent increase in community-diagnosed case incidence.
Gunn
Robert A
RA
Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. robert.gunn@sdcounty.ca.gov
Lee
Marjorie
M
Oh
Christina
C
Brodine
Stephanie
S
D000554:Ambulatory Care Facilities; D002140:California / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015995:Prevalence; D012725:Sexual Behavior; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D013588:Syphilis Serodiagnosis