2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Public Heath Implications

• Two epidemics • MSM networks

• Heterosexual networks • Historic success in heterosexual epidemics • Intensive partner services, contact tracing • Targeted community outreach, screening, treatment to reach at-risk individuals • Less success addressing MSM epidemics • MSM in smaller metropolitan areas and South and Midwest more commonly linked to heterosexual women and less likely to identify (Oster,STD, 2014)

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Primary Syphilis

• Chancre appears 10-90 days after infection • Single, painless, indurated, with rolled edges • Multiple or persistent lesions • Most are asymptomatic • Regional adenopathy (painless) • Primary urethritis Chambers, CID2019

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Secondary Syphilis

• ~3-6 weeks after primary • Rash

• Generalized lymphadenopathy • Constitutionalsymptoms

• Mucouspatches • Condylomata lata • Patchy alopecia

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