Increasing gay men’s testing rates and enhancing partner notification can reduce the incidence of syphilis

Sexual Health ◽  
2012 ◽  
Vol 9 (5) ◽  
pp. 472 ◽  
Author(s):  
Ian Down ◽  
David P. Wilson ◽  
Pol Dominic McCann ◽  
Richard Gray ◽  
Alexander Hoare ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Gay Men ◽  
Online Survey ◽  
Partner Notification ◽  
Population Level ◽  
Anal Intercourse ◽  
Syphilis Infection ◽  
Substantial Impact ◽  
Syphilis Testing ◽  
Sexually Transmissible Infections

Background We sought to determine whether gay men would be willing to increase syphilis testing and partner notification, and assessed the possible epidemiological impact these changes might have in the Australian population. Methods: We conducted an online survey (n = 2306) and focus groups to determine whether interventions to increase testing for syphilis and enhanced partner notification are likely to be acceptable to gay men in Australia. An individual-based mathematical model was developed to estimate the potential population-level impact of changes in these factors. Results: Of all men surveyed, 37.3% felt they should test more frequently for sexually transmissible infections. Men who recent unprotected anal intercourse with casual partners and men who reported a higher number of partners were more likely to indicate a greater willingness to increase testing frequency. HIV-positive men were more likely to indicate that their frequency of syphilis testing was adequate, incorporated as part of their regular HIV monitoring. Lack of convenience was the main barrier reported. Partner notification was broadly acceptable, although perceived stigma presented a potential barrier. The mathematical model indicated that increasing testing rates would have a substantial impact on reducing rates of syphilis infection among gay men and partner notification would further reduce infections. Conclusions: Interventions promoting testing for syphilis among gay men and increases in partner notification may be acceptable to gay men and are likely to result in decreased infection rates. Rapid testing and modern communication technologies could strengthen these interventions, and have an impact on the syphilis epidemic.

scholarly journals Why is syphilis rising in Europe? Multi-level modelling of alternative hypotheses in 31 countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Mendez-Lopez ◽  
D Stuckler ◽  
T Noori ◽  
J C Semenza
Keyword(s):  
Risky Sexual Behavior ◽  
Population Level ◽  
Internet Survey ◽  
Probability Models ◽  
Syphilis Infection ◽  
Detection Rates ◽  
Substantial Impact ◽  
Multi Level ◽  
Sex With Men ◽  
Linear Probability

Abstract Background Syphilis transmission has increased markedly over the past two decades in Europe, concentrated in men who have sex with men. We test alternative potential social and behavioral individual- and population-level determinants of this resurgence. Methods Two rounds of the cross-sectional European Men who have sex with men Internet Survey (EMIS 2010 and 2017, n = 272,902) were used to fit multi-level linear probability models to evaluate determinants of the incidence of self-reported syphilis, capturing risky sexual behaviours and pre-exposure prophylaxis use, among others, adjusting for potential sociodemographic confounders. Results Self-reported syphilis incidence rates rose by about 1.8 percentage points (within the last 12 months) and 3.9 (within the last 5 years) between the 2010 and 2017 waves, after adjusting for sociodemographic factors. HIV status was a major risk factor for syphilis infection (27.6 ppt higher incident rate, 95%CI: 24.7 to 30.5). A dose-response relationship was observed between greater numbers of condomless non-steady partners and syphilis infection, with more than 10 partners estimating increases in the probability of diagnosis of over 25 ppt (11-20 partners vs none: 24.5 ppt, 95%CI: 20.5 to 28.5); further, we observed evidence of mediation for number of condomless non-steady partners, which attenuated the estimated rise in 2017 vs 2010 by about 35%. STI testing uptake also accounted for a substantial increase in syphilis incidence signaling higher detection rates over time. While country-level PrEP use was linked to greater number of condomless partners, there was no substantial impact of population-wide factors, including GDP and PrEP use, on overall syphilis trends. Conclusions Risky sexual behavior changes, particularly condomless sex with non-steady partners, appears to be a major contributing factor to rising syphilis incidence. Further research is needed to understand what accounts for this substantial behavior change. Key messages Increased number of condomless non-steady partners accounts for a substantial rise in syphilis trends. Population-level PrEP use was linked to increasing numbers of condomless non-steady partners but had no substantial impact on overall syphilis trends.

30. TESTING FOR SEXUALLY TRANSMISSIBLE INFECTIONS AMONG GAY MEN IN SYDNEY, AUSTRALIA

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 296 ◽  
Author(s):  
G. Prestage ◽  
I. Zablotska ◽  
A. Frankland ◽  
J. Imrie ◽  
A. Grulich
Keyword(s):  
Gay Men ◽  
Urine Sample ◽  
Blood Test ◽  
Throat Swab ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Gay Community ◽  
Sti Testing ◽  
Sexually Transmissible Infections ◽  
Anal Swab

Introduction: Recently, rates of sexually transmissible infections (STIs) have been increasing among gay men in Australia and elsewhere. We explored trends in STI testing among gay men in Sydney. Methods: We used behavioural data from the six-monthly Sydney Gay Community Periodic Survey (SGCPS). Men are recruited through gay community venues, clinics and events in Sydney. Since 2003 men were asked whether they had received the following tests in the previous year: Anal swab, throat swab, penile swab, urine sample, and blood test for STIs other than HIV. Men recruited from clinics were excluded from the following analyses. Results: In 2006, 3145 completed questionnaires were received from non-clinic sites, with 40.9% of respondents reporting having received an anal swab, 45.4% a throat swab, 34.6% a penile swab, 52.7% a urine sample, and 56.1% a blood test for STIs other than HIV. The majority (67.2%) reported at least one test for STIs, with 25.5% having received all five forms of STI test. Although there was no increase during 2003-2006 in having any STI tests, the proportion of men having received all five types of test increased. The largest increase was in the proportion reporting anal swabs: from 23.8% in 2003 to 40.9% in 2006. Among men reporting unprotected anal intercourse with casual partners (UAIC), as well as among men with more than ten casual partners in the previous six months, rates of STI testing were higher but the time trends were similar. Conclusion: The majority of men report STI testing in the previous year, and this testing has become more comprehensive, with men receiving a broader range of STI tests over time. Men at higher risk for STIs tested at increased rates.

scholarly journals Survey of partner notification practices for sexually transmissible infections in the United States

Sexual Health ◽  
2016 ◽  
Vol 13 (2) ◽  
pp. 162 ◽  
Author(s):  
Fidel A. Desir ◽  
Jessica H. Ladd ◽  
Charlotte A. Gaydos
Keyword(s):  
United States ◽  
Control Method ◽  
Partner Notification ◽  
The United States ◽  
Planned Parenthood ◽  
Syphilis Infection ◽  
Convenience Sample ◽  
Sexually Transmissible Infections ◽  
Cooperation Rate ◽  
Control And Prevention

Background Partner notification (PN) for sexually transmissible infections (STIs) is a vital STI control method. The most recent evaluation of PN practices in the United States, conducted in 1999, indicated that few STI patients were offered PN services. The objectives of this study were to obtain a preliminary understanding of the current provision of PN services in HIV/STI testing sites throughout the US and to determine the types of PN services available. Methods: A convenience sample of 300 randomly selected testing sites was contacted to administer a phone survey about PN practices. These sites were from a large database maintained by the Centers for Disease Control and Prevention. Sites were eligible to participate if they provided testing services for chlamydia, gonorrhoea, HIV or syphilis and were not hospitals or Planned Parenthood locations. Results: Of the 300 eligible sites called, 79 sites were successfully reached, of which 74 agreed to participate, yielding a response rate of 24.7% and a cooperation rate of 93.7%. Most surveyed testing sites provided some form of PN service (anonymous or non-anonymous) on site or through an affiliate for chlamydia (100%), gonorrhoea (97%), HIV (91%) and syphilis (96%) infection. Anonymous PN services were available at 67–69% of sites. Only 6–9% of sites offered Internet-based PN services. Conclusions: Most surveyed testing sites currently offer some type of PN service for chlamydia, gonorrhoea, HIV or syphilis infection. However, approximately one-third of surveyed sites do not offer anonymous services. Novel, Internet-based methods may be warranted to increase the availability of anonymous services.

Behavioural surveillance among gay men in Australia: methods, findings and policy implications for the prevention of HIV and other sexually transmissible infections

Sexual Health ◽  
2011 ◽  
Vol 8 (3) ◽  
pp. 272 ◽  
Author(s):  
Iryna B. Zablotska ◽  
Susan Kippax ◽  
Andrew Grulich ◽  
Martin Holt ◽  
Garrett Prestage
Keyword(s):  
Gay Men ◽  
Warning System ◽  
Anal Intercourse ◽  
Policy Implications ◽  
Cross Sectional ◽  
Sti Prevention ◽  
Gay Community ◽  
Behavioural Surveillance ◽  
Sexually Transmissible Infections ◽  
Over Time

Background The Australian HIV and sexually transmissible infection (STI) behavioural surveillance system (the repeated cross-sectional Gay Community Periodic Surveys, GCPS) has been conducted since 1998 and covers six main Australian jurisdictions. In this paper, we review its history and methodology, and the available indicators, their trends and their use. Methods:We describe the design and history of GCPS. For analyses of indicators, we use Pearson’s χ2-test and test for trend where appropriate. Results: About 90% of gay men in Australia have been tested for HIV (60% to 70% of men who were not HIV-positive) have been tested as recommended in the preceding 12 months. STI testing levels (~70% in the preceding 12 months) are high, but remain insufficient for STI prevention. In general, unprotected anal intercourse with regular (UAIR) and casual (UAIC) sex partners has increased over time. The prevalence and increasing trends in UAIR were similar across jurisdictions (P-trend <0.01), while trends in UAIC differed across the states: during 2001–08, UAIC declined in NSW (P-trend <0.01) and increased elsewhere (P-trend <0.01). Trends in UAIC were associated with HIV diagnoses. Conclusion: This review of the design, implementation and findings of the Australian HIV/STI behavioural surveillance highlights important lessons for HIV/STI behavioural surveillance among homosexual men, particularly the need for consistent data collection over time and across jurisdictions. Investment in systematic behavioural surveillance appears to result in a better understanding of the HIV epidemic, the availability of a warning system and a better targeted HIV prevention strategy.

Barriers to HIV testing among Australian gay men

Sexual Health ◽  
2012 ◽  
Vol 9 (5) ◽  
pp. 453 ◽  
Author(s):  
Garrett Prestage ◽  
Graham Brown ◽  
Phillip Keen
Keyword(s):  
Hiv Testing ◽  
Gay Men ◽  
Online Survey ◽  
Point Of Care ◽  
Anal Intercourse ◽  
Hiv Positive ◽  
Hiv Diagnosis ◽  
Increased Risk ◽  
To Receive ◽  
Hiv Positive Men

Objective To investigate the barriers to HIV testing among Australian gay men. Methods: An online survey was conducted to explore reasons for avoiding and delaying testing for HIV; 519 non-HIV-positive men completed the online survey. Results: Most non-HIV-positive men (92.9%) had been tested for HIV, with 75.4% indicating they had been tested in the previous year. The most common reasons for avoiding or delaying testing were a belief that they had not done anything risky (41.2%) and the need to return for a second clinic visit to receive results (40.3%). Among men who engaged in unprotected anal intercourse with casual partners (UAIC), those who had not been recently tested were more likely to cite the lack of any symptoms as reasons for not having tested (adjusted odds ratio: 2.34; 95% confidence interval: 1.03–5.31; P = 0.041). Conclusions: For men who do not engage in risky sex, the decision not to test is probably reasonable, but those who engage in noncondom-based risk reduction may be at some increased risk and should be encouraged to test relatively often. Changes to Australia’s national HIV testing policy may ameliorate some of the need to return for second clinic visits to receive results, but the policy still requires full implementation, including the introduction of rapid point-of-care HIV testing to Australia. Among men who engage in UAIC, there appears to be a particular need for information about the benefits of early treatment after HIV diagnosis and about the relative likelihood of experiencing HIV seroconversion illness.

scholarly journals Use of Artificial Intelligence to understand adults’ thoughts and behaviours relating to COVID-19

2021 ◽  
pp. 175791392097933
Author(s):  
SW Flint ◽  
A Piotrkowicz ◽  
K Watts
Keyword(s):  
Artificial Intelligence ◽  
Online Survey ◽  
Severe Illness ◽  
Free Text ◽  
Community Recovery ◽  
Substantial Impact ◽  
Lifestyle Behaviours ◽  
Artificial Intelligence Methods ◽  
High Concern ◽  
The Impact

Aims: The outbreak of severe acute respiratory syndrome coronavirus 2 (COVID-19) is a global pandemic that has had substantial impact across societies. An attempt to reduce infection and spread of the disease, for most nations, has led to a lockdown period, where people’s movement has been restricted resulting in a consequential impact on employment, lifestyle behaviours and wellbeing. As such, this study aimed to explore adults’ thoughts and behaviours in response to the outbreak and resulting lockdown measures. Methods: Using an online survey, 1126 adults responded to invitations to participate in the study. Participants, all aged 18 years or older, were recruited using social media, email distribution lists, website advertisement and word of mouth. Sentiment and personality features extracted from free-text responses using Artificial Intelligence methods were used to cluster participants. Results: Findings demonstrated that there was varied knowledge of the symptoms of COVID-19 and high concern about infection, severe illness and death, spread to others, the impact on the health service and on the economy. Higher concerns about infection, illness and death were reported by people identified at high risk of severe illness from COVID-19. Behavioural clusters, identified using Artificial Intelligence methods, differed significantly in sentiment and personality traits, as well as concerns about COVID-19, actions, lifestyle behaviours and wellbeing during the COVID-19 lockdown. Conclusions: This time-sensitive study provides important insights into adults’ perceptions and behaviours in response to the COVID-19 pandemic and associated lockdown. The use of Artificial Intelligence has identified that there are two behavioural clusters that can predict people’s responses during the COVID-19 pandemic, which goes beyond simple demographic groupings. Considering these insights may improve the effectiveness of communication, actions to reduce the direct and indirect impact of the COVID-19 pandemic and to support community recovery.

scholarly journals Temporal Evolution of Immunity Distributions in a Population with Waning and Boosting

Complexity ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-13
Author(s):  
M. V. Barbarossa ◽  
M. Polner ◽  
G. Röst
Keyword(s):  
Mathematical Model ◽  
Steady State ◽  
Temporal Evolution ◽  
Disease Outbreaks ◽  
Population Level ◽  
Coupled System ◽  
Disease Outbreak ◽  
Periodic Disease ◽  
Evolution Of Immunity

We investigate the temporal evolution of the distribution of immunities in a population, which is determined by various epidemiological, immunological, and demographical phenomena: after a disease outbreak, recovered individuals constitute a large immune population; however, their immunity is waning in the long term and they may become susceptible again. Meanwhile, their immunity can be boosted by repeated exposure to the pathogen, which is linked to the density of infected individuals present in the population. This prolongs the length of their immunity. We consider a mathematical model formulated as a coupled system of ordinary and partial differential equations that connects all these processes and systematically compare a number of boosting assumptions proposed in the literature, showing that different boosting mechanisms lead to very different stationary distributions of the immunity at the endemic steady state. In the situation of periodic disease outbreaks, the waveforms of immunity distributions are studied and visualized. Our results show that there is a possibility to infer the boosting mechanism from the population level immune dynamics.

scholarly journals Awareness of and attitudes to sexually transmissible infections among gay men and other men who have sex with men in England: a qualitative study

Sexual Health ◽  
2019 ◽  
Vol 16 (1) ◽  
pp. 18 ◽  
Author(s):  
Jessica Datta ◽  
David Reid ◽  
Gwenda Hughes ◽  
Catherine H. Mercer ◽  
Sonali Wayal ◽  
...  
Keyword(s):  
Health Promotion ◽  
Gay Men ◽  
Treatment Options ◽  
The Body ◽  
Modes Of Transmission ◽  
Treatment Regimens ◽  
Transmission Mechanisms ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
Health Promotion Interventions

Background Rates of sexually transmissible infections (STIs) have increased over recent years among gay men and other men who have sex with men (MSM) in England and Wales. HIV diagnoses remain high in this group and men with diagnosed HIV are disproportionally affected by STIs. MSM are therefore a priority for health promotion efforts to reduce STIs. Understanding awareness of and attitudes towards STIs is essential in developing health promotion interventions to reduce prevalence. Methods: Eight focus group discussions (FGDs) with a total of 61 MSM in four English cities included a ranking exercise to gauge how ‘scary’ participants thought 11 STIs are. The exercise sought insights into participants’ awareness of, knowledge about and attitudes towards STIs and blood-borne viruses (BBVs). FGDs were audio-recorded, transcribed and data analysed thematically. Results: All groups ranked HIV and Hepatitis C virus (HCV) as the scariest infections, and the majority ranked syphilis and herpes as highly scary. Scabies was ranked as the least scary by most groups. Rankings were dependent on how well informed participants felt about an infection, its transmission mechanisms, health affect and the availability of vaccines and treatment. Personal experience or that of friends influenced perceptions of particular infections, as did their prevalence, treatment options, visibility of symptoms and whether an STI could be cleared from the body. Conclusions: The study findings suggest that, although some MSM are well informed, there is widespread lack of knowledge about the prevalence, modes of transmission, health implications and treatment regimens of particular STIs.

scholarly journals Modelling the population-level protection conferred by COVID-19 vaccination

2021 ◽  
Author(s):  
Pranesh Padmanabhan ◽  
Rajat Desikan ◽  
Narendra M Dixit
Keyword(s):  
Mathematical Model ◽  
Severe Acute Respiratory Syndrome ◽  
Dose Response ◽  
Neutralizing Antibodies ◽  
Population Level ◽  
Response Curves ◽  
Post Vaccination ◽  
Dose Response Curves ◽  
Vaccine Availability

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines work predominantly by eliciting neutralizing antibodies (NAbs), how the protection they confer depends on the NAb response to vaccination is unclear. Here, we collated and analysed in vitro dose-response curves of >70 NAbs and constructed a landscape defining the spectrum of neutralization efficiencies of NAbs elicited. We mimicked responses of individuals by sampling NAb subsets of known sizes from the landscape and found that they recapitulated responses of convalescent patients. Combining individual responses with a mathematical model of within-host SARS-CoV-2 infection post-vaccination, we predicted how the population-level protection conferred would increase with the NAb response to vaccination. Our predictions captured the outcomes of vaccination trials. Our formalism may help optimize vaccination protocols, given limited vaccine availability.

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