Infectious syphilis outbreaks among gay and other homosexually active men in Canada and Australia – is testing and treatment the answer?
Issues: Since the early 2000s, rates of infectious syphilis have been increasing exponentially, with the majority of cases occurring among gay and other homosexually active men. Looking at two prevention strategies developed in Toronto, Canada and Melbourne, Australia, we will ask: Are prevention strategies founded on testing and treatment sufficient to curb this epidemic?
Description: The response in Toronto was a collaborative intervention between Toronto Public Health (TPH), the Hassle Free Clinic (HFC), and the AIDS Committee of Toronto (ACT), and dovetailed into the existing testing sites at sex on premises venues frequented by gay and other homosexually active men.
The response of the Victorian AIDS Council/Gay Men’s Health Centre by contrast dovetailed into an existing national general sexual health campaign for gay and other homosexually active men, to capitalize on brand recognition nation wide.
In Toronto, rates in 2004 were ten times their 2002 equivalent, but began to drop in 2005 and stayed fairly level in 2006 at 247 notifications. While rates in Victoria were slower to increase, they rose from 28 notifications in 2002 to 410 in 2007.
Lessons learned: The collaborative efforts in Toronto benefited from the shared resources of the three partner agencies – peer outreach volunteers from ACT, and clinical expertise of the nurses from TPH and the HFC. In Melbourne, the health educators’ access to various media such as community radio and sexual health allowed for more thorough dissemination of testing and prevention messages.
Next steps: While it is unknown whether the infection rates levelled off in Toronto as a result of the prevention programs, Melbourne’s rates may provide some more support for testing and treatment based prevention programs.
-Abstract available at link below-