State officials question mandatory STD testing

For years, critics have argued that Mississippi lags behind all other states when it comes to progress – economic other otherwise. And last week, some state and health officials argued that Mississippi is imposing a further economic burden with its required syphilis testing for engaged couples.

According a report in the Clarion-Ledger “Mississippi could have saved more than $3 million in the last 10 years by eliminating premarital syphilis screening.”

State Rep. Sidney Bondurant, R-Grenada, who is also a physician, tried to have the mandatory testing repealed during the last legislative session. His bill was defeated.

“If you’re looking to screen for disease,” he said, “you can have universal or selective testing. Which is what this is, selecting those who have a marriage license. But in this case, the selection is in a fairly low risk group.”

Bondurant said if the state wants to enforce syphilis testing on residents, it should be on a group at a higher risk for the disease. Such as those already being treated for other sexually transmitted diseases, young adults or individuals who are sexually active.

The Clarion-Ledger further said that syphilis cases identified through premarital testing typically have been less than one percent nationally. Mississippi is the only state that still requires couples take a blood test before marriage, but it consistently ranks near the top for sexually transmitted disease.

The National Institute of Medicine released a report in 1997 that questioned the effectiveness of premarital blood tests for syphilis and recommended all states revoke laws that require blood tests before marriage. About 10 states have followed the institute’s advice, but the Mississippi Legislature has yet to quash the premarital provision.

Bondurant, who practices obstetrics and gynecology in Grenada, said he’s yet to see a positive case of syphilis in premarital testing.

“I’ve been doing this since the mid-1970s, and I have had some [syphilis] cases that were suspicious or in selected patients, but never in premarital cases. And this seems to me to be a waste of resources.”

State Rep. Bobby Howell, R-Kilmichael, agreed. He said:

“Of course we should take the moral high ground and not do anything that would encourage [sex before marriage]. But I would think, like Dr. Bondurant, there’s a lot more high risk people out there that your resources spent on testing would be better served.”

Howell, a licensed pharmacist and owner of Kilmichael Pharmacy for more than 40 years, said the number of patients obtaining medication for syphilis is relatively few.

“I’ve never seen any alarming cases as a community practitioner,” he said. “One is too many. But I’ve never seen what I would call an epidemic or an outbreak.”

Out of 26,285 premarital syphilis tests in fiscal 2007, about 0.3 percent detected new syphilis cases, a health department spokesman said.

Syphilis is a sexually transmitted disease (STD) and is passed from person to person through direct contact with a syphilis sore. Sores occur mainly on the external genitals. Pregnant women with the disease can pass it to their unborn child.

Syphilis can appear in primary and secondary stages and can result in, but is not limited to, rashes, internal organ damage, blindness and death. Many people infected with syphilis may not exhibit symptoms for years and transmission may occur from persons who are unaware of their infection. Syphilis can be treated with penicillin.

Blood screenings for syphilis can be performed at county health departments or by private physicians at an average cost of $10 per person. Mississippi spends about $330,000 on premarital blood tests each year.

Bondurant said he spoke with State Health Officer Dr. Ed Thompson before he presented his amendment.

“I called him to be sure that I wasn’t doing something they had objections to and I wanted to get their input before I did it,” he said. “And this is really routine if you put in a bill or an amendment that affects a state agency. You want their input. And this is something they had looked at too, and they felt it was not cost effective and the dollars could have been spent in other ways.”

Bondurant said ideally, he would like to see that money used for syphilis prevention and control by funding more STD investigators assigned to track down syphilis carriers. Once that person has been identified investigators would in turn contact each of his or her sexual partners in attempt to keep the infection from spreading.

Bondurant said his bill failed because some officials worried that stopping the blood tests would hurt tourism in Mississippi by hindering couples from spending their honeymoon in the state. Bondurant said that was a “weak reason” to oppose his proposal, but that he may try again in the future.

“Most of the time if you get beat, you don’t try again unless you do more preliminary work and you have a lot more allies going into to it,” he said. “But I feel like the resources the health department spent doing this could have been used for something other than this test because it’s such a slow pick up.”

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