Screening for Syphilis must for individuals who are at high risk: USPSTF reaffirms

The U.S. Preventive Services Task Force has reaffirmed its recommendation to screen those at increased risk for syphilis, citing an increase in the incidence of  infections over the past 2 decades.

The US Preventive Services Task Force (USPSTF) recommendations have been  published in the Journal of American Medical Association.

Syphilis is a sexually transmitted illness that, if left untreated, can advance through several stages (primary, secondary, latent, and tertiary) and cause major health consequences. In the United States, reported occurrences of primary and secondary syphilis surged from a low of 2.1 cases per 100,000 people in 2000 and 2001 to 11.9 cases per 100,000 people in 2019. Men account for the vast majority of infections (83% of primary and secondary syphilis cases in 2019), whereas female rates nearly quadrupled between 2015 and 2019.

The USPSTF commissioned a reaffirmation evidence update focused on specific core issues examining the effectiveness of risk assessment tools and the benefits and harms of screening for syphilis in nonpregnant adolescents and adults to reaffirm its 2016 recommendation. This research was designed for asymptomatic, nonpregnant adolescents and adults who have ever been sexually active and are at high risk of syphilis infection.

The CDC advises yearly syphilis screening in sexually active males who have intercourse with men, including confirmatory testing for those who show reactive serology. The CDC advises that people with HIV who are sexually active be checked during their first HIV checkup and then at least yearly after that. Individuals who have sex with other men and those living with HIV may benefit from more regular screening (e.g., every 3 to 6 months) based on individual risk behaviors and local epidemiology. Based on the local region and institutional incidence, the CDC also advises opt-out syphilis screening in correctional facilities.

Depending on risk, the HIV Medicine Association, a division of the Infectious Diseases Society of America, advises that all patients with HIV infection have syphilis screening at the beginning of their care and on an ongoing basis. The USPSTF recommendations for screening for syphilis in people at greater risk are identical to the advice provided by the American Academy of Family Physicians.

Reference: 

Mangione, C. M., Barry, M. J., Nicholson, W. K., Cabana, M., Chelmow, D., Coker, T. R., Davis, E. M., Donahue, K. E., Jaén, C. R., Kubik, M., Li, L., Ogedegbe, G., Pbert, L., Ruiz, J. M., Stevermer, J., & Wong, J. B. (2022). Screening for Syphilis Infection in Nonpregnant Adolescents and Adults. In JAMA (Vol. 328, Issue 12, p. 1243). American Medical Association (AMA). https://doi.org/10.1001/jama.2022.15322