Abstract
Access to Benzathine Penicillin G for Syphilis Patients in Maricopa County, Arizona
APHA 2022 Annual Meeting and Expo
Background: Nationally, all stages of syphilis, including congenital syphilis, are increasing each year. The gold standard treatment for syphilis is Benzathine Penicillin G (BPG). BPG is associated with high costs, specific storage requirements and recent shortages. As a result, BPG access is often limited to public health departments and facilities eligible for 340B funding.
Objectives: Characterize where syphilis cases receive BPG by quantifying and comparing the diagnosing sites for syphilis cases to the treatment site for initial BPG injections for all stages of syphilis in Maricopa County, AZ.
Methods: Syphilis cases diagnosed in Maricopa County, Arizona during January 1, 2021 to December 31, 2021 who were interviewed by a communicable disease investigator were included. Demographic and treatment data were extracted from the state-run database (PRISM). The lab ordering provider of positive syphilis cases and treatment sites for first injection of BPG were collated and compared for these cases.
Results: In Maricopa County in 2021, 1,977 cases met inclusion criteria. Results were displayed in aggregate by lab ordering site and treatment site type (e.g. correctional facility, hospital). Outcomes of interest included the Maricopa County Sexually Transmitted Disease Clinic who diagnosed 596 (30.1%) of countywide syphilis cases and treated 1,406 (71.1%) cases. Obstetrics and gynecology offices who diagnosed 117 (5.9%) cases and treated 3 (0.2%) cases.
Conclusions: Discrepancies exist between diagnosing provider and treatment provider, highlighting concerns regarding access to BPG. A burden is placed on patients who must leave their primary provider to seek treatment at STD clinics or other health facilities.