Document Type

Capstone Experience

Graduation Date

8-2022

Degree Name

Master of Public Health

Department

Biostatistics

First Committee Member

Lynette M. Smith

Second Committee Member

Melissa K. Tibbits

Third Committee Member

George Walton

Abstract

Background:

Syphilis is easily detectable and treatable with the appropriate medical attention, yet national incidence rates have been on the rise since reaching an all-time low in 2000 (Shockman et al, 2014). Similar to HIV, men who have sex with other men (MSM), represent most syphilis transmission, yet in recent years, syphilis rates have concerningly increased among both genders and among all racial/ethnic groups (CDC, 2019).

Methods:

Surveillance data was collected on all syphilis cases reported to the Iowa Department of Public Health (IDPH) regarding demographics and risk factors of cases. Variables were analyzed using chi-square and Fisher’s exact tests, to compare 2016 cases to 2021 cases as well as compare infectious syphilis in Iowa to chlamydia, gonorrhea, and national infectious syphilis cases. Logistic regression was used to model demographics associated with infectious syphilis in comparison to chlamydia and gonorrhea

Results:

Compared to 2016, 2021 Iowa infectious syphilis cases were associated with more females, Black individuals, Hispanic individuals, urban counties, incarcerated individuals, cases not reporting meeting partners via the internet, and MSW and WSM. Considerable disparities by demographics were uncovered as the highest incidence of infectious syphilis in 2021 Iowa infectious syphilis occurred in Black males aged 30-34 with a rate of 375 cases per 100,000 while White males of this age group had a rate of 50 cases per 100,000. Compared to chlamydia and gonorrhea, Iowa infectious syphilis cases were more associated with males, older age groups, and urban counties. Similar incidence rates by demographics and gender were found in national syphilis cases.

Conclusions:

While syphilis was once almost on the verge of eradication, in the recent few years cases have continued to soar nationwide causing concern among public health officials. This report found demographic disparities and risk factors associated with the rise in cases in Iowa from 2016-2021.

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