P079 Syphilis Reinfection among Women: Florida and Louisiana, USA 2000–2018

Background Syphilis rates have continued to rise in the United States. Florida and Louisiana consistently report high numbers of cases. In a previous study, reinfections accounted for 30.4% of new infections among men in 2018. In this analysis, we evaluated rates of reported reinfections in women. Methods We evaluated all syphilis records, all stages (primary, secondary, early latent, and late latent) in females aged 15–70 years from the Florida and Louisiana Departments of Health surveillance databases during 2000–2018. Demographics of cases and repeaters (individuals reported with 2 or more cases of syphilis) were examined. Percentages of syphilis cases from repeaters by year were calculated as were percentages from HIV+ females. Results From 2000–2018, 124,827 syphilis cases were reported from 107,405 individuals: 33,594(31%) were female accounting for 35,279(28%) of all cases. Of 33,594 females, 32,050(95%) reported a single episode of syphilis and 1,544(5%) were repeaters. Most women with a single case report were African American 18,429(57.5%) and 1,510(4.7%) of single cases were HIV+. Women with a single episode of syphilis were likely in the age range of 20–39 (primary child-bearing years) 20,037(63%). Repeaters were primarily African American 914(59.2%) and 218(14.1%) were HIV+. Women reported with two or more episodes of syphilis also were likely to be of child-bearing age 20–39: 1,065(69%). Repeaters had 1,685 cases reported; range 2 to 5. Mean time to second infection was 3.5 years (median=2.3 years). From 2010–2018, repeaters accounted for a slowly increasing percentage of all syphilis reported: 2010 (5.1%), 2013 (5.9%), 2016 (6.8%), and reached (10.3%) in 2018. Within females living with HIV, cases from repeaters also increased: 2010 (13%), 2014 (16%), 2016 (21%), and 2018 (25%). Conclusion Most syphilis diagnosed in Florida and Louisiana was among persons infected for the first time and among men. However, syphilis infection and reinfections are increasing in women.