"Donut Stress, Just Test": The Importance of Early Detection

The “Donut Stress Just Test” campaign was launched as part of the routine screening project by the Iowa PCA in fall 2021. The campaign was developed to raise awareness and promote CDC and United State Preventive Services Task Force (USPSTF) recommendations for opt-out HIV, HCV, and STI screening at Iowa’s community health centers. By using the opt-out model, community health centers are well positioned to reduce barriers patients may experience and promote linkage to care. It is recommended that all patients aged 13-65 are screened at least once in a lifetime for HIV. In addition to HIV, all patients between the ages of 18-79 should be screened at least once in their lifetime for HCV regardless of risk factors. It is also recommended all sexually active females under the age of 25 are screened for STIs.  

Recently in Iowa, syphilis cases have significantly risen. In fact, there has been a 224% increase in early syphilis cases between 2018 to 2021.  Populations that were less affected in the past are increasingly becoming affected. In many cases signs and symptoms may not be obvious and missed or confused with other conditions. If caught early syphilis can be treated with a single dose of Bicillin L-A. Clinical presentation and laboratory diagnostics are essential in staging, determining treatment, and monitoring follow-up. To help in reducing these rates, it is recommended to ask several key questions to clients/patients when screening and testing for syphilis:

• Have you ever tested positive for syphilis in the past?
• When was the last time you were tested for syphilis?
  • What was the result of your last syphilis test?
  • Where did you get your last syphilis test (clinic/medical provider)?
• Have you had any signs or symptoms of syphilis in the past 12 months (chancres, rashes, etc.)?
• When was the last time you had sex?
• Have you had sex with anyone who has tested positive for syphilis or who has had signs/symptoms of syphilis?

By testing for syphilis, an early diagnosis can be made leading to early treatment, better patient outcomes, and a reduction in transmission risk in our communities. Another great reason to “donut stress, just test!”