Amid rising cases, Orange County jail screens inmates for syphilis
Faced with rising syphilis cases, health care providers are testing some of the people who may need screening the most: inmates.
In April, the Orange County jail began testing inmates for syphilis upon admission hoping to reach people who might otherwise go undiagnosed. So far, the program has tested more than 1,400 people for syphilis – 981 male, 473 female – and diagnosed 17 new cases, said Dr. Gregorie Constant-Peter, medical director for the Corrections Health Services Department.
After testing positive, people can receive treatment at the jail or through community partners.
“The ability to care for the whole person that is with us, whether it’s for any [sexually transmitted disease], including syphilis, is really big,” Constant-Peter said.
Syphilis – a sexually transmitted disease that can cause permanent organ damage and death if untreated – increased by nearly 80% nationwide in the five years before 2022, the latest year of data available, according to the U.S. Centers for Disease Control and Prevention.
Orange County documented 1,830 cases in 2022, a rate of 122.4 cases for every 100,000 residents. This was the sixth-highest syphilis rate of any Florida county, according to Florida Department of Health data.
Syphilis cases spike in Florida, especially in Orange County
Inmates can opt out of testing, but most are willing to participate, Constant-Peter said. For more than seven years, the jail has used the nonprofit Hope and Help Center of Central Florida to conduct HIV screening, and the syphilis rapid blood test is administered at the same time by the same people, she said.
Syphilis testing is done in partnership with the Orange County Health Services Department, the CDC and the National Association of County and City Health Officials. The program is funded through July by the National Association of County and City Health Officials, after which the jail will continue to offer syphilis testing if state and federal funding allows.
Before this program, inmates could still receive syphilis testing and treatment at the jail, but tests weren’t given immediately, said Raul Pino, director of the Orange County Health Services Department. Most people who land in jail leave within 72 hours, which didn’t leave enough time to administer a test and follow up, Pino said.
It’s important to target this population because people in correctional facilities have higher rates of STDs and are less likely to have access to regular medical care, Pino added.
“A lot of commercial sex workers, a lot of men having sex with men, a lot of minorities that are at higher risk … are part of our jail population,” Pino said. “That makes it a little bit of a concentrated place where you have a higher number of people at risk than in the normal distribution in the community.”
Early syphilis tests and treatment are especially vital for women, who can become pregnant and pass on syphilis to their babies without realizing it.
There’s recently been a sharp increase in the number of babies born with syphilis in the United States, and Florida is no exception. From 2016 to 2022, Florida saw a 128% increase in its rate of babies born with syphilis according to data from the Florida Department of Health.
Florida had 276 babies born with syphilis in 2022, a rate of 127.6 per 100,000 live births — the 14th highest rate of any state, according to the CDC.
“Any patient that comes through here … that’s one female patient that doesn’t have to worry about exposing their fetus to congenital syphilis,” Constant-Peter said.
Other Florida counties have similar programs. The CDC recommends screening all inmates at entry for HIV and hepatitis, screening women 35 and younger and men under 30 for chlamydia and gonorrhea, and screening for syphilis in areas like Orange County where the disease is prevalent.
Sharon Reiley, a nurse practitioner in Jacksonville with the AIDS Healthcare Foundation, previously worked within a similar STD testing program at the Duval County jail.
Reiley said testing people in jail is crucial to protecting the entire community.
“It’s really an extension of public health,” she said.
