Access to Benzathine Penicillin G Treatment for Persons With Syphilis, Maricopa County, Arizona, 2021.
Journal
Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941
Informations de publication
Date de publication:
01 Mar 2024
01 Mar 2024
Historique:
medline:
27
2
2024
pubmed:
27
2
2024
entrez:
27
2
2024
Statut:
ppublish
Résumé
As the incidence of syphilis continues to increase, examining benzathine penicillin G (BPG) treatment data provides valuable insight for public health strategies. This study analyzed the trends of where BPG is administered relative to the initial clinical site of syphilis diagnosis. Our findings are timely in the context of recent national BPG shortages. The analysis included persons diagnosed with any syphilis stage in Maricopa County, Arizona, from January 1, 2021, to December 31, 2021. The Arizona surveillance database (PRISM) was the source of demographic, testing, and treatment data. Of a total of 4028 persons with syphilis, 3038 (75.4%) received at least 1 injection of BPG. Among persons who received an initial BPG injection, only 1719 (56.6%) were diagnosed and treated at the same clinical site type. The Maricopa County Sexually Transmitted Disease Clinic administered BPG to 48.8% (n = 1483) of persons with syphilis who received an initial injection. Our findings analyze trends in BPG administration that are likely due to treatment referral practices and medication cost. Administration of BPG is not guaranteed at the clinical site of diagnosis, highlighting concerns regarding access to BPG. A burden is placed on patients who are required to leave their diagnosing provider to seek syphilis treatment at other health facilities that administer BPG.
Sections du résumé
BACKGROUND
BACKGROUND
As the incidence of syphilis continues to increase, examining benzathine penicillin G (BPG) treatment data provides valuable insight for public health strategies. This study analyzed the trends of where BPG is administered relative to the initial clinical site of syphilis diagnosis. Our findings are timely in the context of recent national BPG shortages.
METHODS
METHODS
The analysis included persons diagnosed with any syphilis stage in Maricopa County, Arizona, from January 1, 2021, to December 31, 2021. The Arizona surveillance database (PRISM) was the source of demographic, testing, and treatment data.
RESULTS
RESULTS
Of a total of 4028 persons with syphilis, 3038 (75.4%) received at least 1 injection of BPG. Among persons who received an initial BPG injection, only 1719 (56.6%) were diagnosed and treated at the same clinical site type. The Maricopa County Sexually Transmitted Disease Clinic administered BPG to 48.8% (n = 1483) of persons with syphilis who received an initial injection.
CONCLUSIONS
CONCLUSIONS
Our findings analyze trends in BPG administration that are likely due to treatment referral practices and medication cost. Administration of BPG is not guaranteed at the clinical site of diagnosis, highlighting concerns regarding access to BPG. A burden is placed on patients who are required to leave their diagnosing provider to seek syphilis treatment at other health facilities that administer BPG.
Identifiants
pubmed: 38412466
doi: 10.1097/OLQ.0000000000001921
pii: 00007435-202403000-00009
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
192-198Informations de copyright
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Sexually Transmitted Diseases Association.
Déclaration de conflit d'intérêts
Conflict of Interest and Sources of Funding The authors declared no potential conflicts of interest with respect to the public health surveillance activities, authorship, and/or publication of this article. The authors received no financial support for the surveillance work, authorship, and/or publication of this article.
Références
Centers for Disease Control and Prevention (CDC). Sexually Transmitted Disease Surveillance 2021, Table 12. Total Syphilis. Washington, DC: US Department of Health and Human Services, Centers for Disease Control and Prevention. 2023.
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep 2021; 70:1–187.
Bicillin LA. Goodrx.com. Available at: https://www.goodrx.com/bicillin-l-a. Published March 26, 2023. Accessed March 26, 2023.
U.S. Department of Veteran Affairs. Office of Procurement, Acquisition and Logistics (OPAL). Veterans Affairs. Published 2022. Accessed January 10, 2022.
Seghers F, Taylor MM, Storey A, et al. Securing the supply of benzathine benzylpenicillin: A global perspective on risks and mitigation strategies to prevent future shortages. Int Health 2013; 8:227. doi:10.1093/inthealth/ihad087Maricopa bal Heart.
doi: 10.1093/inthealth/ihad087Maricopa bal Heart
Health Resources and Services Administration. 340B Eligibility. HRSA. Available at: Available at: https://www.hrsa.gov/opa/eligibility-and-registration. Updated June 30, 2022. Accessed January 14, 2023.
Arnold Pang SS, Fratto E. 340B Basics and Beyond. National Association of Counsel and City Health Officials (NACCHO) and National Coalition of STD Directors (NCSD). 2022. Available at: https://www.ncsddc.org/resource/340b-basics-and-beyond/. Accessed March 26, 2023.
Injectable Syphilis Treatment Delivery: Considerations for STD Programs. National Coalition of STD Directors. Published May 2023. Available at: https://www.ncsddc.org/resource/injectable-syphilis-treatment-delivery-considerations-for-std-programs/. Accessed October 21, 2023.
Mangone E, Bell J, Khurana R, et al. Treatment completion with three-dose series of benzathine penicillin among people diagnosed with late latent and unknown duration syphilis, Maricopa County, Arizona. Sex Transm Dis 2023; 50:298–303.
Chen SY, Johnson M, Sunenshine R, et al. Missed and delayed syphilis treatment and partner elicitation: A comparison between STD clinic and non-STD clinic patients. Sex Transm Dis 2009; 36:445–451.
US Food and Drug Administration. Current and Resolved Drug Shortages and Discontinuations Reported to FDA. Available at: https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Penicillin%20G%20Benzathine%20Injection&st=c. Accessed January 22, 2024.
Cha S, Matthias JM, Rahman M, et al. Reactor grids for prioritizing syphilis investigations: Are primary syphilis cases being missed? Sex Transm Dis 2018; 45:648–654. PMID: 29528995; PMCID: PMC6129433.
A.A.C. R9-6-204. Arizona Laboratory Reporting Requirements. Phoenix, AZ: Arizona Department of Health Services, 2018.
Arizona Health Care Cost Containment System. AHCCCS federally qualified healthcare centers and rural health clinics. AZAHCCCSgov. Available at: https://www.azahcccs.gov/PlansProviders/RatesAndBilling/FFS/FQHC-RHC.html. Published 2023. Accessed October 21, 2023.
Robinson CL, Young L, Bisgard K, et al. Syphilis time to treatment at publicly funded sexually transmitted disease clinics versus non–sexually transmitted disease clinics—Maricopa and Pima Counties, Arizona, 2009–2012. Sex Transm Dis 2016; 43:30–33.
Bell J, Canepa S, Kreis S, et al. Impact of COVID-19 lockdowns on sexual health care utilization and STD reporting, Maricopa County. Inquiry 2021; 58:469580211055583.
Collier MG, Taylor MM, Winscott MM, et al. Assessing compliance with a county board order for third trimester syphilis screening in Maricopa County, Arizona. Sex Reprod Healthc 2011; 2:125–128.
U.S. Department of Health and Human Services. Sexually Transmitted Infections National Strategic Plan for the United States: 2021–2025. 2020. Available at: https://www.hhs.gov/sites/default/files/STI-National-Strategic-Plan-2021-2025.pdf.
Reduce congenital syphilis—STI-04—Healthy People 2030 | health.gov. Healthgov. Available at: https://health.gov/healthypeople/objectives-and-data/browse-objectives/sexually-transmitted-infections/reduce-congenital-syphilis-sti-04. Published 2020. Accessed November 6, 2023.
Chesson HW, Peterman TA. The estimated lifetime medical cost of syphilis in the United States. Sex Transm Dis 2021; 48:253–259.
Chan EYL, Smullin C, Clavijo S, et al. A qualitative assessment of structural barriers to prenatal care and congenital syphilis prevention in Kern County, California. PLoS One 2021; 16:e0249419.
Nurse-Findlay S, Taylor MM, Savage M, et al. Shortages of benzathine penicillin for prevention of mother-to-child transmission of syphilis: An evaluation from multi-country surveys and stakeholder interviews. PLoS Med 2017; 14:e1002473.
Taylor MM, Wi T, Gerbase A, et al. Assessment of country implementation of the WHO Global Health Sector Strategy on Sexually Transmitted Infections (2016–2021). PLoS One 2022; 17:e0263550.
Centers for Disease Control and Prevention (CDC). Sexually Transmitted Disease Surveillance 2021, Table 20. Congenital Syphilis. Washington, DC: US Department of Health and Human Services, Centers for Disease Control and Prevention, 2023.
Centers for Disease Control and Prevention (CDC). Sexually Transmitted Disease Surveillance 2021, Table 13. Primary and Secondary Syphilis. Washington, DC: US Department of Health and Human Services, Centers for Disease Control and Prevention. 2023.
Maricopa County Public Health. Maricopa County coordinated community health needs assessment 2020–2023. Maricopagov. Available at: https://www.maricopa.gov/DocumentCenter/View/68104/Final-CHA-30-Report. Published 2020. Accessed March 8, 2023.