title: A Quality Improvement Project to Increase Early Detection of Syphilis Infection or Re-infection in HIV-infected Men Who Have Sex With Men.
abstract: Our quality improvement project evaluated whether testing for syphilis every 3 to 6 months with routine HIV laboratory monitoring had an effect on early detection of asymptomatic syphilis infection/re-infection in HIV-infected men who have sex with men. Retrospective analysis of syphilis testing and infections in a sample of this population (N = 245) was conducted after establishing a change-of-practice quality improvement initiative in a not-for-profit, community-based, grant-funded clinic. We compared the clinic's annual rates of syphilis before and after intervention implementation. The detection rate was 6.6% in the preintervention practice change group and 15.5% in the postintervention group. Increased testing identified 27 syphilis cases that would not otherwise have been identified until the annual comprehensive examination. Increased testing frequency led to earlier detection of syphilis, which was clinically significant, showing a potential to decrease the number of new syphilis and HIV infections and to decrease health care expenditures.
authors.forename: Miyesha A
authors.initials: MA
authors.lastname: Cheeks
authors.forename: Mesfin
authors.initials: M
authors.lastname: Fransua
authors.forename: Harold G
authors.initials: HG
authors.lastname: Stringer
authors.forename: Susan
authors.initials: S
authors.lastname: Silva
authors.forename: Michael
authors.initials: M
authors.lastname: Relf
mesh_terms: D000554:Ambulatory Care Facilities; D042241:Early Diagnosis; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D058996:Quality Improvement; D012189:Retrospective Studies; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology; D013588:Syphilis Serodiagnosis; D014210:Treponema pallidum / Q000302:isolation & purification*
keywords: HIV; men who have sex with men; screening; syphilis