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Community based syphilis screening: feasibility, acceptability, and effectiveness in case finding.

N L Lambert1, M Fisher, J Imrie

  • 1HIV/GUM Research Department, Residence Block, Brighton General Hospital, Elm Grove, Brighton, UK.

Sexually Transmitted Infections
|June 1, 2005
PubMed
Summary
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Community-based syphilis screening is feasible and acceptable for at-risk men who have sex with men (MSM), reaching those not using traditional genitourinary medicine (GUM) clinics. Saliva testing increased uptake in specific venues.

Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Sexual Health

Background:

  • Syphilis remains a significant public health concern, particularly among men who have sex with men (MSM).
  • Traditional genitourinary medicine (GUM) clinics may not reach all at-risk populations.
  • Community-based screening offers an alternative approach to increase testing accessibility.

Purpose of the Study:

  • To assess the feasibility and acceptability of community-based syphilis screening among MSM.
  • To compare different sample collection techniques (venepuncture vs. saliva) for syphilis screening.
  • To evaluate the effectiveness of this approach in identifying new syphilis cases in at-risk populations.

Main Methods:

  • Two-phase community-based syphilis screening conducted in venues frequented by MSM.

Related Experiment Videos

  • Phase 1 utilized venepuncture; Phase 2 employed a validated saliva test.
  • Evaluation involved quantitative data from testers and clinics, and qualitative data from staff.
  • Main Results:

    • 1090 MSM were screened over 7 weeks; 62% had not attended a GUM clinic in the past year.
    • High-risk sexual behaviors were prevalent (64% reported ≥2 sexual contacts in 90 days).
    • Syphilis diagnosis rates were similar for both phases (1.4% vs. 1.8%), but saliva testing showed greater uptake in saunas.

    Conclusions:

    • Community-based syphilis screening is feasible and acceptable for at-risk MSM.
    • This approach successfully reaches populations not routinely accessing GUM services.
    • While unlikely to contain outbreaks alone, combined screening and health promotion strategies may enhance effectiveness.