Chemoprophylaxis Is Likely to Be Acceptable and Could Mitigate Syphilis Epidemics Among Populations of Gay Men

Abstract

Chemoprophylaxis offers promise as an acceptable and effective intervention for mitigating syphilis epidemics. The outcomes of a planned placebo-controlled syphilis chemoprophylaxis trial are eagerly anticipated.

Trends in transfusion‐transmissible infections among Australian blood donors from 2005 to 2010

“…Our finding of a gradually increasing trend in active syphilis infection among Australian blood donors may be due to the resurgence of syphilis in Australia, particularly among gay men, a trend also observed in other developed countries like the United Kingdom and the United States and Germany and Canada . The rate of infectious syphilis diagnosis increased more than twofold in the male population in Australia during the period of 2004 to 2007 and increases were almost completely limited to men who have sex with men .…”

Sexually transmissible infection control programs for men who have sex with men – what will they look like in 2020?

“…Daily chemoprophylaxis to reduce syphilis incidence was reported to be acceptable among MSM. 32 Additionally, mathematical models have shown that syphilis chemoprophylaxis may have a substantial impact on the epidemic. 33 Daily doxycycline may only be appropriate for a subset of MSM for whom the benefits outweigh the possible risks.…”

Syphilis transmission: a review of the current evidence

“…58 In an online survey conducted among MSM in Australia, over 50% of respondents stated that they would be likely to take daily pills to decrease their personal chance of syphilis infection, and over 75% were willing to take daily medication if it would result in a decrease in syphilis infections in the gay community. 59 A recent pilot study found that a daily dose of doxycycline to prevent syphilis infection in high-risk MSM was well-tolerated and that medication adherence was high. 60 Mathematical modelling of ongoing antibiotic prophylaxis in high-risk MSM has supported the effectiveness of such an intervention in significantly reducing new cases of syphilis in a community for a period of time, with a likely rebound in cases following discontinuation of the intervention.…”

“…60 Mathematical modelling of ongoing antibiotic prophylaxis in high-risk MSM has supported the effectiveness of such an intervention in significantly reducing new cases of syphilis in a community for a period of time, with a likely rebound in cases following discontinuation of the intervention. 59 …”