Since 2018, Texas has faced a steep rise in syphilis cases particularly among marginalized groups such as Hispanic and non-Hispanic Black individuals. These findings are parallel to HIV trends in Texas.

A local sexual health program partnered with its healthcare system’s sexual health clinic and the local health department (supported by Gilead FOCUS since 2023) to systematically review daily notifiable syphilis reports. For confirmed adult cases (18+, HIV-negative), the STI nurse contacts patients electronically or by phone, provides education on the syphilis–HIV link, discusses prevention and PrEP, and schedules a PrEP initiation visit.

Based on early STI trends, the clinic expects ~23 new adult syphilis cases per month. With a 25 % PrEP linkage rate, this likely translates to around 6 new monthly PrEP starts among new syphilis diagnoses in the healthcare system.

This model merges surveillance with proactive prevention and clinical coordination, targeting individuals at heightened HIV risk. Ongoing data collection on patient demographics, barriers, and facilitators will optimize implementation and elevate prevention outcomes in underserved communities.