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Abstract INTRODUCTION: Sexually transmitted infections (STIs) are the secondary endpoint in the Carraguard® Phase 3 trial, thus it is important that recurring infections are treated optimally. National treatment guidelines for treatment of syphilis recommend intramuscular injection of benzithine penicillin weekly over three weeks. Nonadherence to syphilis treatment schedules is often due to ignorance of treatment adherence, fear of injection, and full-time employment. METHOD: Participants are screened for syphilis prior to enrollment and at selected scheduled visits. Treatment is offered to women if syphilis is newly diagnosed at a titer ≥1:2 or an increase ≥4-fold between scheduled visits. We assessed adherence to syphilis treatment between two time points, October 2004–May 2005 (first period); and after implementation of a strategy between May 2005 and September 2005 (second period). For the former we provided contact cards as reminders. Poor response was the impetus to developing a tool that consisted of a participant-tracking log detailing treatment dates and participant contact numbers. Differences in adherence pattern were then assessed. RESULTS: For the first period, 1,312 women were screened, 2.29% (30) were seropositive for syphilis. 53.33% (16) returned for the first dose, 36.66% (11) for the second dose, and 36.66% (11) for the third dose. 36.66% (11) completed treatment over three consecutive weeks, 16.67% (5) defaulted on the first dose, and 46.67% (14) did not return for treatment. Overall 63.34% (19) defaulted complete treatment. For the second period, the tool was implemented. Of the 433 women screened, 3.00% (13) were seropositive for syphilis. 69.23% (9) returned for the first dose, 46.15% (6) for the second dose, and 46.15% (6) for the third dose. 46.15% (6) completed treatment over three consecutive weeks, 23.07% (3) defaulted on the first dose, and 30.76% (4) did not return for treatment. Overall there was an increase in adherence to treatment from 36.66% to 46.15% after the strategy was implemented. CONCLUSION: The adherence to treatment tool has ensured compliance to syphilis treatment as per South African guidelines. Poster Session
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