Acceptance of syphilis screening among residents of high-STD-risk Houston communities

The purpose of this study was to assess the rate of acceptance of street-in tercept syphilis screening and to identify barriers to screening among resi dents of 2 Houston communities with high rates of syphilis. Each of 691 peo ple who participated in a street-intercept survey about syphilis was offere d a free syphilis test immediately after completion of the survey. Acceptor s of screening had blood drawn at the site of the interview, and blood samp les were tested by rapid plasma reagin (RPR) and a confirmatory microhaemag glutination-Treponema pallidum (MHA-TP) for those with a positive antibody reaction on the RPR. On-street syphilis screening was accepted by 26% of th e sample. The most common reason for refusal was not wanting to have blood drawn (19.5%). Among those screened for syphilis (n=148), seroprevalence wa s 19%, with 33% of women testing positive and 10% of men. The results of th is study point to a need for increased case-finding, standard screening rec ommendations, and interventions targeting specific barriers to syphilis scr eening.