Assessing Syphilis Partner Services in Georgia (2013-2024): Effectiveness in Partner Notification and Impact on Reinfection.

BACKGROUND

Partner services (PSs) are a cornerstone of syphilis control efforts in the United States, facilitating exposed partner treatment and interrupting onward transmission of infection. However, current data on their effectiveness in Georgia are limited, despite persistently high syphilis rates and evolving sexual networks.

METHODS

We analyzed early syphilis diagnoses (primary, secondary, early nonprimary nonsecondary) reported in the Georgia State Electronic Notifiable Disease Surveillance System, 2013-2024. We assessed PS engagement (interviews completed; partners reported, named, located, treated), following case assignment and patient contact attempts. The unlocatable partner pool (comprising partners mentioned without identifying details to enable treatment linkage and estimated unreported partners) was quantified. Associations with syphilis reinfection within 2 years were evaluated using multivariable Poisson regression adjusted for sex, age, and race/ethnicity.

RESULTS

Of 38,118 eligible patients, 60% completed a PS interview, 51% reported ≥1 partner, 25% named ≥1 partner with sufficient information to enable outreach, and 9% had ≥1 partner treated. Of an estimated 150,720 potentially exposed partners, only 10% had sufficient identifying details for follow-up. The proportion of unlocatable partners increased from 86% in 2013 to 95% in 2023. Having ≥1 unlocatable partner was associated with a higher likelihood of syphilis reinfection within 2 years (adjusted prevalence ratio, 1.40; 95% confidence interval, 1.28-1.53).

CONCLUSIONS

Syphilis PSs face increasing challenges in reaching exposed individuals, with most exposed partners remaining unlocatable. Strengthening PS and incorporating innovative patient-centered strategies that better align with current sexual network dynamics may be important for reducing syphilis infections.