{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T10:16:42Z","timestamp":1789208202190,"version":"build-2803163510"},"reference-count":10,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,10,6]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the outcomes of a street medicine intervention offering syphilis testing and treatment to people experiencing homelessness in South Los Angeles, California\u2014a population disproportionately affected by syphilis and underserved by traditional healthcare systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From September 2024 to January 2025, a multidisciplinary street medicine team provided testing and treatment for syphilis during outreach visits to patients experiencing homelessness. A total of 99 patients were tested using the reverse syphilis testing algorithm. Demographic data included gender, race\/ethnicity, substance use disorder, mental illness and HIV status. \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests were used to evaluate associations between syphilis diagnosis and each demographic characteristic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-six (36.4%) of the 99 patients had reactive syphilis test results, with 94.4% (n=34) classified as late-stage infections. Of those diagnosed, 72.2% (n=26) were treated during follow-up visits. Statistically significant associations were found between syphilis diagnosis and gender (p=0.002), substance use disorder (p=0.008) and HIV status (p=0.020). Patients identifying as female or transgender female, and those with cooccurring substance use disorder or HIV, were more likely to be diagnosed with syphilis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates the feasibility and outcomes of delivering sexually transmitted infection care through street medicine. The high prevalence of late-stage syphilis and its syndemic overlap with substance use disorder and HIV underscores the need for low-barrier, community-based services. Street medicine interventions should be recognised and resourced as essential tools in public health responses to rising syphilis rates, particularly among unhoused populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056690","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T07:05:19Z","timestamp":1761289519000},"page":"255-257","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Syphilis testing and treatment outcomes among people experiencing homelessness: a street medicine intervention in South Los Angeles, California"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8862-230X","authenticated-orcid":false,"given":"Josephine Yoolie","family":"Kim","sequence":"first","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8793-2166","authenticated-orcid":false,"given":"Adam Carl","family":"Sukhija-Cohen","sequence":"additional","affiliation":[{"name":"Center for Health Systems Research, Sutter Health, Palo Alto, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1183-3887","authenticated-orcid":false,"given":"Suhail Abdeen","family":"Samidon","sequence":"additional","affiliation":[{"name":"University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manda Beth","family":"Robinson","sequence":"additional","affiliation":[{"name":"Wellness Equity Alliance, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jose","family":"Ordenana","sequence":"additional","affiliation":[{"name":"Wellness Equity Alliance, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6063-0344","authenticated-orcid":false,"given":"Mark Roy","family":"McGrath","sequence":"additional","affiliation":[{"name":"Wellness Equity Alliance, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"2026051905450663000_102.4.255.1","unstructured":"Centers for Disease Control and Prevention . About syphilis. 2025. Available: https:\/\/www.cdc.gov\/syphilis\/about\/index.html"},{"key":"2026051905450663000_102.4.255.2","unstructured":"Centers for Disease Control and Prevention . Sexually transmitted disease surveillance 2021. 2023. Available: https:\/\/www.cdc.gov\/sti-statistics\/media\/pdfs\/2024\/07\/2021-STD-Surveillance-Report-PDF_ARCHIVED-2-16-24.pdf"},{"key":"2026051905450663000_102.4.255.3","unstructured":"California Department of Public Health . Sexually transmitted diseases control branch. syphilis. 2025. Available: https:\/\/www.cdph.ca.gov\/Programs\/CID\/DCDC\/Pages\/Syphilis.aspx"},{"key":"2026051905450663000_102.4.255.4","unstructured":"Los Angeles Homeless Services Authority . 2023 Greater Los Angeles homeless count deck. 2023. Available: https:\/\/www.lahsa.org\/documents?id=7232-2023-greater-los-angeles-homeless-count-deck"},{"key":"2026051905450663000_102.4.255.5","unstructured":"California Department of Public Health . California Department of Public Health (CDPH) updates syphilis screening recommendations. 2024. Available: https:\/\/www.cdph.ca.gov\/Programs\/OPA\/Pages\/CAHAN\/CDPH-Updates-Syphilis227 Screening-Recommendations.aspx"},{"key":"2026051905450663000_102.4.255.6","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s10900-022-01119-y","article-title":"Access to Healthcare and the Utilization of Sexually Transmitted Infections Among Homeless Medicaid Patients 15 to 44 Years of Age","volume":"47","author":"Patel","year":"2022","journal-title":"J Community Health"},{"key":"2026051905450663000_102.4.255.7","unstructured":"Centers for Disease Control and Prevention . Homelessness and health. about homelessness and health. 2024. Available: https:\/\/www.cdc.gov\/homelessness-and-health\/about\/index.html"},{"key":"2026051905450663000_102.4.255.8","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.2105\/AJPH.94.7.1081","article-title":"\u201cStreet medicine\u201d: Collaborating with a faith-based organization to screen at-risk youths for sexually transmitted diseases","volume":"94","author":"Moss","year":"2004","journal-title":"Am J Public Health"},{"key":"2026051905450663000_102.4.255.9","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph21060760","article-title":"The Role of Street Medicine and Mobile Clinics for Persons Experiencing Homelessness: A Scoping Review","volume":"21","author":"Kaufman","year":"2024","journal-title":"Int J Environ Res Public Health"},{"key":"2026051905450663000_102.4.255.10","unstructured":"State of California\u2014Health and Human Services Agency . Department of health care services. street medicine provider: definitions and participation in managed care. 2022. Available: https:\/\/www.dhcs.ca.gov\/formsandpubs\/Documents\/MMCDAPLsandPolicyLetters\/APL2022\/APL22-023.pdf"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:45:29Z","timestamp":1779194729000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,23]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,5,19]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/sextrans-2025-056690"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056690","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,23]]}}}