PROVIDERS OF SYPHILIS CARE IN THE SOUTHERN UNITED-STATES

Background and Objectives: The nadir in syphilis incidence in the 1950 s provided evidence that current control methods could eliminate the t ransmission of syphilis, Planning such an effort will require informat ion on the current state of the public and private infrastructure for the control of sexually transmitted disease(STD), Goal of This Study: To evaluate the accessibility; acceptability, and quality of delivery of clinical and preventive outreach services for syphilis control in t he southern United States, Study design: A telephone-and-questionnaire survey of the 7 largest southern city, 10 state, and 9 nonsouthern co mparison state STD central programs, Results: The gender-race composit ion of public-sector STD providers is very different from their client s, Median ratio of STD clinicians per 1994 infectious syphilis patient was 0.08 (0.01-0.25) in southern states and 0.50 (0.07-1.00) in compa rison states. The proportion of clients treated,within one day of care -seeking in southern states was 58% to 100%; regions with inadequate a ccess were common. A median of 45% to 50% of patients with presumptive congenital syphilis underwent recommended diagnostic procedures, Conc lusions: Serious deficiencies exist in the accessibility of STD care i n the south that make the elimination of syphilis transmission difficu lt using current clinic-based diagnosis and treatment. A more communit y-based program of case finding and presumptive treatment may be indic ated.