Adapting the HIV Screening Model to Address the Syphilis Epidemic and Create HIV Prevention Opportunities (SAEM Transmissible Infectious Disease (Formerly EMTIDE) and Evidenced-Based Healthcare & Implementation Interest Groups Sponsored)

Syphilis rates have been rising steadily over the past decade, and there is considerable interest in studying novel means of intervening on this epidemic. Building on the established model for routine, opt-out HIV screening that has been proven to be effective at reaching populations that might otherwise be difficult to access, several emergency departments (EDs) have begun to implement syphilis screening. Screening ED patients for syphilis has the potential to not only identify syphilis among populations of patients who might otherwise go untested and undiagnosed, but also to identify individuals who are at increased risk for acquiring HIV infection and who would benefit from comprehensive HIV prevention services, including pre-exposure prophylaxis. How to best integrate syphilis screening into ED processes and into existing HIV screening programs is unclear. There are diverse models for implementing syphilis screening currently being implemented in U.S. EDs, ranging from focusing on only patients being tested for sexually transmitted infections to screening all ED patients. This didactic will present the rationale behind screening for syphilis, lessons learned about the implementation of targeted versus universal screening, and the pathway between syphilis screening and HIV prevention. The speakers will be two ED physicians who are experts on HIV and syphilis screening and who have direct experience implementing both universal HIV screening, diverse HIV prevention models, and targeted and universal syphilis screening programs in their own EDs.

Presenters:

Kim Stanford, MD, MPH
Douglas A. White, MD

Authors

Kim Stanford, MD, MPH

University of Chicago

Kimberly Stanford, MD, MPH, is an Associate Professor at the University of Chicago and the Director of ED HIV and Sexually Transmitted Infection (STI) Screening at the Chicago Center for HIV Elimination (CCHE). A nationally recognized expert on screening for syphilis and HIV in the ED, Dr. Stanford is an NIH-funded implementation scientist whose research focuses on leveraging the emergency department visit as a key point of contact with the healthcare system for patients who might otherwise have limited access to care, creating opportunities for critical public health interventions related to infectious and chronic diseases and social determinants of health.
Douglas A. White, MD

Alameda Health System–Highland Hospital

Dr. Douglas White is an emergency medicine physician at Highland Hospital in Oakland, California. Since 2004, he has advocated for routine, integrated HIV, hepatitis C virus, and syphilis screening in US emergency departments through a platform of implementation science research, technical assitance, and advocacy work.