title: Missed and delayed syphilis treatment and partner elicitation: a comparison between STD clinic and non-STD clinic patients.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. chens@azdhs.gov
authors.forename: Sanny Y
authors.initials: SY
authors.lastname: Chen
authors.forename: Michelle
authors.initials: M
authors.lastname: Johnson
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sunenshine
authors.forename: Bob
authors.initials: B
authors.lastname: England
authors.forename: Ken
authors.initials: K
authors.lastname: Komatsu
authors.forename: Melanie
authors.initials: M
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D001130:Arizona; D016358:Contact Tracing; D018563:Disease Notification; D005260:Female; D006078:Government Programs; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D013587:Syphilis / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D013997:Time Factors; D055815:Young Adult