Scaling up syphilis testing in China: implementation beyond the clinic.
China is experiencing a syphilis epidemic of enormous proportions. The regions most heavily affected by syphilis correspond to regions where sexually transmitted HIV infection is also a major public health threat. Many high-risk patients in China fail to receive routine syphilis screening. This missed public health opportunity stems from both a failure of many high-risk individuals to seek clinical care and a disconnect between policy and practice. New point-of-care syphilis testing enables screening in non-traditional settings such as community organizations or sex venues. This paper describes the current Chinese syphilis policies, suggests a spatiotemporal framework (based on targeting high-risk times and places) to improve screening and care practices, and emphasizes a syphilis control policy extending beyond the clinical setting.
Tucker
Joseph D
JD
Massachusetts General Hospital, 100 Blossom Street, Boston, MA 02114, USA. jtucker4@partners.org
Hawkes
Sarah J
SJ
Yin
Yue-Pin
YP
Peeling
Rosanna W
RW
Cohen
Myron S
MS
Chen
Xiang-Sheng
XS
D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005843:Geography; D006291:Health Policy; D006295:Health Resources; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008403:Mass Screening; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011203:Poverty; D011295:Prenatal Care; D011634:Public Health / Q000379:methods*; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D012959:Socioeconomic Factors; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D013997:Time Factors