Open AccessCharacterizing female infectious syphilis cases in British Columbia to identify opportunities for optimization of care
Author(s) -
Kaylie Willemsma,
Lindsay Barton,
Rochelle Stimpson,
Irene Pickell,
Venessa Ryan,
Amanda Yu,
Ann Pederson,
Gina Ogilvie,
Troy Grennan,
Jason Wong
Publication year - 2022
Publication title -
canada communicable disease report
Language(s) - English
Resource type - Journals
eISSN - 1481-8531
pISSN - 1188-4169
DOI - 10.14745/ccdr.v48i23a03
Subject(s) - syphilis , medicine , congenital syphilis , mental illness , demography , incidence (geometry) , transactional sex , psychiatry , mental health , human immunodeficiency virus (hiv) , family medicine , environmental health , population , physics , optics , sociology , research methodology
The rate of infectious syphilis continues to increase among females in British Columbia (BC) and Canada, raising concerns of increased incidence of congenital syphilis. We characterized syphilis cases among females in BC to identify opportunities to prevent syphilis and optimize its care. Methods: All cases of infectious syphilis diagnosed in BC between March 13, 2018 and December 31, 2020 and reported as female gender were reviewed. Demographics, risk factors and concurrent conditions were collected from a provincial surveillance system. Subgroup analyses comparing cases with and without housing instability, substance use, mental illness and a recent sexually transmitted infection (STI) were conducted to understand differences between these subgroups. Statistical associations were calculated using chi–square or t-tests. Results: There were 226 reported cases of female infectious syphilis in BC during this period: 38 (16.8%) in 2018; 74 (32.7%) in 2019; and 114 (50.4%) in 2020. Mean age was 32 years (range 15–75 years). Of those who reported concurrent conditions, most cases had experiences with housing instability (71.1%), substance use (68.2%) and mental illness (83.9%), while 42.9% had a recent STI. Cases who reported housing instability or substance use were significantly more likely to have experiences with a recent STI, street involvement, transactional sex, mental illness and income assistance (all p<0.01). Conclusion: Our findings highlight the importance of fostering an enabling environment for syphilis care. Concurrent services to support individuals with syphilis as well as housing instability, substance use and mental illness, may help prevent syphilis and improve wellbeing.