Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

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

Jason A. Trubiano A B and Jennifer F. Hoy A
+ Author Affiliations
- Author Affiliations

A Department of Infectious Diseases, The Alfred Hospital and Monash University, Melbourne, Vic. 3004, Australia.

B Corresponding author. Email: j.trubiano@alfred.org.au

Sexual Health 12(2) 176-178 https://doi.org/10.1071/SH14164
Submitted: 22 August 2014  Accepted: 2 November 2014   Published: 22 December 2014

Abstract

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).

Additional keywords: HIV, MSM, screening, sexually transmissible infections, syphilis.


References

[1]  Guy R, Leslie D, Simpson K, Hatch B, Leydon J, et al Sustained increase in infectious syphilis notifications in Victoria. Med J Aust 2005; 183 218
| 16097926PubMed |

[2]  Jin F, Prestage G, Kippax S, Pell C, Donovan B, et al Epidemic syphilis among homosexually active men in Syndey. Med J Aust 2005; 183 179–83.
| 16097913PubMed |

[3]  Peterman TA, Heffelfinger JD, Swint EB, Groseclose SL. The changing epidemiology of syphilis. Sex Transm Dis 2005; 32 S4–10.
The changing epidemiology of syphilis.Crossref | GoogleScholarGoogle Scholar | 16205291PubMed |

[4]  Victorian Department of Health. AIDS 2014 Victorian prevention, epidemiology and surveillance. Available online at: http://docs.health.vic.gov.au/docs/doc/224AA0DFD8AAF202CA257D190019A34C/$FILE/Victorian%20Prevention%20Epidemiology%20and%20Surveillance%20%E2%80%93%20STI%20update.pdf [verified 12 September 2014].

[5]  Guy RJ, Spelman T, Stoove M, El-Hayek C, Goller J, et al Risk factors for HIV seroconversion in men who have sex with men in Victoria, Australia: results from a sentineal surveillance system. Sex Health 2011; 8 319–29.
Risk factors for HIV seroconversion in men who have sex with men in Victoria, Australia: results from a sentineal surveillance system.Crossref | GoogleScholarGoogle Scholar | 21851771PubMed |

[6]  England Public Health. Sexually transmitted infections and Chlamydia screening in England, 2012. Public Health England. Health Protection Weekly Report, Volume 7 (issue 23), London: Public Health England; 2013.

[7]  Bissessor M, Fairley CK, Leslie D, Howley K, Chen MY. Frequent screening for syphilis as part of HIV monitoring increased the detection of early asymptomatic syphilis among HIV-positive homosexual men. J Acquir Immune Defic Syndr 2010; 55 211
Frequent screening for syphilis as part of HIV monitoring increased the detection of early asymptomatic syphilis among HIV-positive homosexual men.Crossref | GoogleScholarGoogle Scholar | 20585261PubMed |

[8]  Templeton DJ, Read P, Varma R, Bourne C. Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence. Sex Health 2014; 11 217–29.
Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence.Crossref | GoogleScholarGoogle Scholar | 24690473PubMed |

[9]  Australian STI Management Committee. Australian STI guidelines. Available online at: http://www.sti.guidelines.org.au/sexually-transmissible-infections/syphilis#diagnosis [verified 12 September 2014].

[10]  Down I, Wilson DP, McCann D, Gray R, Hoare A, Bradley J, Donovan B, Prestage G. Increasing gay men’s testing rates and enhancing partner notification can reduce the incidence of syphilis. Sex Health 2012; 9 472
Increasing gay men’s testing rates and enhancing partner notification can reduce the incidence of syphilis.Crossref | GoogleScholarGoogle Scholar | 23380198PubMed |

[11]  Guy R, El-Hayek C, Fairley C, Wand H, Carr A, McNulty A, Hoy J, Bourne C, McAllister J, Tee BK, Baker D, Roth N, Stoove M, Chen M. Opt-Out and Opt-In testing increases syphilis screening of HIV-positive men who have sex with men in Australia. PLoS ONE 2013; 8 e71436
Opt-Out and Opt-In testing increases syphilis screening of HIV-positive men who have sex with men in Australia.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhtl2iu7jF&md5=1f03ea7d5a39580881da2886bf1975a7CAS | 24009661PubMed |

[12]  Cohen C, Winston A, Asboe D, Boag F, Mandalia S, et al Increasing detection of asymptomatic syphilis in HIV patients. Sex Transm Infect 2005; 81 217–9.
Increasing detection of asymptomatic syphilis in HIV patients.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2MzgvFKrtg%3D%3D&md5=b871f2632801c436a8a9df7ed275ec53CAS | 15923288PubMed |

[13]  Dukers-Muijrers NH, Niekamp AM, Vergoossen MM, Hoebe CJ. Effectiveness of an opting-out strategy for HIV testing: evaluation of 4 years of standard HIV testing in a STI clinic. Sex Transm Infect 2009; 85 226–30.
Effectiveness of an opting-out strategy for HIV testing: evaluation of 4 years of standard HIV testing in a STI clinic.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MznsFCktA%3D%3D&md5=ecd40104aca2db134c6af6ab83cb15acCAS | 19103641PubMed |