Routine Emergency Department Screening Reduces Congenital Syphilis: CROI 2024 Highlight

While at the 2024 Conference on Retroviruses and Opportunistic Infections (CROI) last month, HIV.gov discussed an innovative syphilis screening program that is helping to prevent congenital syphilis with Kimberly Stanford, MD, MPH, Associate Professor of Medicine at the University of Chicago. She spoke with Miguel Gomez, Director of HIV.gov. Watch their conversation:

Routine Syphilis Screening in Emergency Department Successful, Replicable

Chicago, like the nation, has experienced a recent surge in syphilis and congenital syphilis cases. In response, Dr. Stanford and her team implemented a routine, non-targeted, opt-out syphilis screening program in a large, urban hospital’s emergency department (ED). A review of the records of all pregnant people who presented to the ED in the two years before and after implementing the screening program found a substantial increase in the proportion who were screened for syphilis (from 6% to 50%). Even more importantly, they found a 750% increase in the number of syphilis cases diagnosed among pregnant persons (from 2 to 15). None of the pregnant women diagnosed with syphilis through routine screening had presented at the ED with symptoms of a sexually transmitted infection (STI), so under the previous standard of care, they would not have been tested for syphilis.

The findings indicate that there had been missed opportunities for syphilis diagnosis and prevention of congenital syphilis under the prior approach. Screening all pregnant people for syphilis and providing early treatment for people with syphilis and their sexual partner(s) during prenatal care can completely prevent congenital syphilis. Dr. Stanford and colleagues concluded that since the ED is often the primary source of healthcare for many communities with limited access to care, visits to the ED may represent a crucial opportunity for syphilis detection and congenital syphilis prevention.

Dr. Stanford observed that a growing number of EDs have already adopted routine HIV screening and that her study demonstrates that routine syphilis screening can be easily added to that with significant results. “The intervention reached pregnant women and made a huge difference in how many were, in fact, screened and diagnosed.”

View the abstract of the study by Dr. Stanford and colleagues, Routine Emergency Department Screening Increases Syphilis Diagnosis Among Pregnant PatientsExit Disclaimer. View the poster presentation of their findingsExit Disclaimer.

The study was supported by funding from NIH’s National Institute of Allergy and Infectious Diseases.

Syphilis and other STIs, HIV, hepatitis C, and substance use disorder can be co-occurring conditions and are part of a syndemic, or the clustering and interaction of two or more diseases, impacted by social and structural determinants of health, which leads to excess burden of disease in a population.

Learn more about the rise of congenital syphilis in the U.S. and the need for tailored prevention approaches to address newborn syphilis disparities. Read CDC’s U.S. Syphilis Cases in Newborns Continue to Increase: A 10-Times Increase Over a Decade.

Catch Up on Other CROI Research Updates

HIV.gov has shared other interviews from CROI 2024 with federal HIV leaders, participating researchers, and community members. You can find all of them on HIV.gov’s social media channels and with recaps here on the blog available by using the CROI topic tag.

About CROI

More than 3,600 HIV and infectious disease researchers gathered from March 3-6, 2024, for CROI, an annual scientific meeting on the latest research that can help accelerate global progress in the response to HIV and other infectious diseases, including STIs. Over 1,000 summaries of original research were presented. Visit the conference websiteExit Disclaimer for more information.