Taming the great: enhanced syphilis screening in HIV-positive men who have sex with men in a hospital clinic setting

Syphilis incidence in HIV-positive men who have sex with men (MSM) continues to increase, with strategies based on early detection and treatment urgently required to control rising infections. There are barriers to enhanced testing in certain settings. At our tertiary referral HIV centre, testing rates before and after a period of enhanced syphilis testing in HIV-positive MSM were assessed. When compared with the control period (pre-enhanced screening), the enhanced syphilis testing was associated with a significant increase in syphilis testing of HIV-positive patients undergoing routine viral load testing (136 out of 574, 23% vs 317 out of 574, 55%; P < 0.0001) and a three-fold increase in new syphilis diagnoses (4 out of 574 vs 18 out of 574, P = 0.004).

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Increasing syphilis rates among men who have sex with men and screening to detect asymptomatic infection

Sexual Health ◽

10.1071/sh17037 ◽

2017 ◽

Vol 14 (4) ◽

pp. 301 ◽

Cited By ~ 1

Author(s):

Marcus Chen ◽

Rebecca Guy

Keyword(s):

Viral Load ◽

Hiv Testing ◽

Asymptomatic Infection ◽

Hiv Positive ◽

Load Testing ◽

Serological Testing ◽

Hiv Viral Load ◽

Ocular Syphilis ◽

Syphilis Screening ◽

Sex With Men

With reports of increasing syphilis rates among men who have sex with men in various countries and complications such as ocular syphilis and neurosyphilis, greater efforts for promoting frequent syphilis screening of higher risk men are required. This should include serological testing for syphilis every time HIV testing is undertaken and each time HIV viral load testing is performed in HIV-positive men who have sex with men. Systems-based approaches tailored to particular contexts should be explored, evaluated and, if shown to be effective, implemented.

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Cost-Effectiveness of Enhanced Syphilis Screening among HIV-Positive Men Who Have Sex with Men: A Microsimulation Model

PLoS ONE ◽

10.1371/journal.pone.0101240 ◽

2014 ◽

Vol 9 (7) ◽

pp. e101240 ◽

Cited By ~ 16

Author(s):

Ashleigh R. Tuite ◽

Ann N. Burchell ◽

David N. Fisman

Keyword(s):

Cost Effectiveness ◽

Hiv Positive ◽

Microsimulation Model ◽

Syphilis Screening ◽

Sex With Men ◽

Hiv Positive Men

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Significant increase in testing rates for sexually transmissible infections following the introduction of an anal cytological screening program, targeting HIV-positive men who have sex with men

Sexual Health ◽

10.1071/sh10027 ◽

2011 ◽

Vol 8 (1) ◽

pp. 76 ◽

Cited By ~ 10

Author(s):

Leon P. Botes ◽

John McAllister ◽

Edward Ribbons ◽

Fengyi Jin ◽

Richard J. Hillman

Keyword(s):

Screening Program ◽

Health Benefit ◽

Prevalence Ratio ◽

Hiv Positive ◽

Sti Testing ◽

Number Of Patients ◽

Sexually Transmissible Infections ◽

Before And After ◽

Sex With Men ◽

Hiv Positive Men

ObjectivesTo evaluate whether the introduction of an anal cytology screening program (ACSP) targeting HIV-positive men who have sex with men (MSM) affected rates of sexually transmissible infection (STI) testing and detection in an urban HIV outpatient clinic. Methods: STI testing was offered as part of an ACSP. Uptake of STI testing and diagnoses were compared before and after the introduction of an ACSP. Results: The number of men undergoing STI testing increased significantly from 67 (20.4%) to 123 (34.8%) (relative risk 1.7, 95% confidence interval (CI) 1.40–2.07), but the increase in the total number of patients with any STI did not achieve significance (from 7 to 11, prevalence ratio 0.86, 95% CI 0.33–2.21). Rates of STI diagnosed in men participating in the ACSP were no different (11.3% v. 7.7%, P = 0.557) from those men declining screening. Conclusions: STI testing, when combined with an ACSP in HIV-positive MSM, may lead to an increase in STI testing and increased opportunities for risk reduction interventions. Men participating in an ACSP appear to have similar risk of STIs to those who decline participation in an ACSP. The inclusion of STI testing could potentially enhance the public health benefit of ACSPs.

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