(P265) Trends in Early Syphilis Partner Notification Services in Heterosexual Men, Pregnant Women, and Non-Pregnant Women from 2014-2021, North Carolina, US

Introduction: Compared to men, high rates of women with syphilis have a partner found and treated due to partner notification service (PNS) interventions. We assessed trends in PNS outcomes in women and heterosexual men in North Carolina (NC), United States during a period when syphilis rates were increasing.

Methods: We reviewed early syphilis cases (primary, secondary, early latent) reported from 2014-2021 in NC and identified cases among non-pregnant women, pregnant women, and heterosexual men. Within each group, we calculated yearly proportions and described trends for cases that a) reported partners (named or unnamed), b) reported named partners and c) reported named partners treated for syphilis (preventatively, prior to PNS, or due to PNS).

Results: From 2014-2021, reported cases among women and heterosexual men in NC increased 312% from 293 to 1,207. The proportion of people who reported ≥1 sex partner was between 84% to 89% most years analyzed, with an outlier of 81% in 2020. Beginning in 2017, a smaller proportion of non-pregnant women reported partners (80%) compared to pregnant women (89%) and heterosexual men (89%). During 2014-2021, we observed declines in the proportion of women and heterosexual men who named ≥1 partner (72%-65%) and who named ≥1 treated partner (58%-45%). Across all years, higher proportions of pregnant women named ≥1 partner and named ≥1 treated partner compared to non-pregnant women and heterosexual men. However, the proportion of pregnant women who named ≥1 partner decreased 10 percent during 2014-2021 (90% to 80%). The proportion of pregnant women who named ≥1 treated partner increased from 65% to 80% between 2014-2016, before decreasing to 62% in 2021. The proportion of non-pregnant women who named ≥1 treated partner dropped from 61% in 2014 to 45% in 2021, which was similar to the proportion in heterosexual men (44%).

Conclusion: As syphilis increased, the ability of PNS to locate and treat partners of women and heterosexual men decreased. This decline occurred despite women being investigated with intensified effort to prevent congenital syphilis. Reasons for the decline in naming partners and assuring partner treatment are needed to improve PNS and increase its effectiveness among heterosexual populations.