Improving Sexually Transmitted Disease Health Services for Gays

Henderson, R. H.

doi:10.1097/00007435-197704000-00007

Cited by 28 publications

(6 citation statements)

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“…11–14 As the epidemic became concentrated among MSM, some even questioned whether the long-term practice of premarital syphilis screening remained important. 15 Rates of syphilis tripled during the 1960s and 1970s as the male-to-female ratio of infections also increased.…”

Section: Syphilis and Homosexuality (Fig 1)mentioning

confidence: 99%

Evolution of the syphilis epidemic among men who have sex with men

Solomon¹,

Mayer²

2015

Sex. Health

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Syphilis has existed for millenni, but its epidemiology was only recently linked to men who have sex with men (MSM) after the introduction of penicillin in the 1940s; the syphilis epidemic became concentrated within the MSM community in subsequent decades. The HIV/AIDS epidemic in the 1980s led to a surge of new syphilis cases and revealed the potentiation between HIV and syphilis, as evidenced by a shift in the natural history of neurosyphilis. In response, MSM revolutionised their sexual behaviour by implementing community-driven seroadaptive strategies to stem HIV transmission. The Centers for Disease Control in the US called for the elimination of syphilis in the late 1990s since the rates had fallen sharply but this effort was overtaken by a resurgence of global outbreaks among MSM in the 2000s, many of which were linked to methamphetamine use and sexual networking websites. Syphilis remains highly prevalent today, especially among MSM and individuals infected with HIV, and it continues to present a significant public health conundrum. Innovative syphilis prevention strategies are warranted. MSM engaging in high-risk behaviour such as condomless anal receptive intercourse, sex with multiple partners or recreational drug use should be routinely screened for syphilis infection; they should also be counselled about the limits of seroadaptive behaviours and HIV pre-exposure prophylaxis as they relate to syphilis transmission.

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Section: Syphilis and Homosexuality (Fig 1)mentioning

confidence: 99%

Evolution of the syphilis epidemic among men who have sex with men

Solomon¹,

Mayer²

2015

Sex. Health

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“…Regular screening for sexually transmitted infection (STI) has been a cornerstone of sexual health promotion for gay men for over three decades 1 and is central in STI and HIV prevention. 2 To be effective STI screening needs to be comprehensive, based on the clients' sexuality, partnerships and risk practices.…”

Section: Introductionmentioning

confidence: 99%

Improvements in sexual health testing among gay men in Sydney, Australia, 2003–2007

et al. 2008

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In order to be effective, sexually transmitted infection (STI) testing should be comprehensive based on the clients' sexuality and risk practices. Using data from the Sydney Gay Community Periodic Survey, we explored trends in and factors associated with STI testing among gay men during 2003-2007. Among men who were not HIV-positive, 68% were tested for HIV in 2007. HIV testing was more common than STI testing and remained stable during 2003-2007. Use of swabs and urine samples increased significantly (P-trend<0.001 for each). However, until 2007, 33% of men were not tested. Sexual behaviours (higher number of partners, having casual partners and engaging in unprotected anal intercourse with them) were associated with STI testing. HIV-negative men were tested for STI less often than HIV-positive men (prevalence ratio=0.56; 95% CI: 0.47-0.68). STI testing among HIV-negative men has improved significantly but remains inadequate for STI control and HIV prevention. It should not be assumed that appropriate and comprehensive STI screening is always provided to clients.

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“…We found no papers in the literature that described interventions that successfully decreased syphilis rates among MSM. In the 1970’s there were calls for gay-friendly services to decrease stigma, 7, 21, 22 and screening in bars and bathhouses found some infections. 23, 24 However, investigators noted that “the population is very large, and our efforts must be viewed more as surveillance than as control programs.” 23 Screening can help limit progression to disease.…”

Section: Discussionmentioning

confidence: 99%

Syphilis in the United States: on the rise?

Peterman¹,

Bernstein

et al. 2014

Expert Review of Anti-infective Therapy

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Syphilis rates and trends vary by population subgroup. Among men who have sex with men (MSM), rates of primary and secondary (P&S) syphilis are high throughout the USA (228.8 per 100,000 in 2013). P&S syphilis among women is much less common (0.9 per 100,000 in 2013) and occurs in isolated outbreaks plus in a few counties with persistent low levels of infection. Congenital syphilis trends closely follow P&S trends among women. These trends have implications for prevention. Routine screening among MSM can prevent tertiary syphilis, but despite interventions, rates of infection continue to rise among MSM and will soon approach those last seen in 1982 (estimate: 340.7 per 100,000). Control of syphilis among women is possible and important because it often leads to congenital syphilis. Outbreaks among heterosexuals can be halted by intensive screening, treatment and partner notification.

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Improving Sexually Transmitted Disease Health Services for Gays

Cited by 28 publications

References 0 publications

Evolution of the syphilis epidemic among men who have sex with men

Evolution of the syphilis epidemic among men who have sex with men

Improvements in sexual health testing among gay men in Sydney, Australia, 2003–2007

Syphilis in the United States: on the rise?

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