Syphilis self-testing

a nationwide pragmatic study among men who have sex with men in China

Cheng Wang, Weibin Cheng, Changchang Li, Weiming Tang, Jason J. Ong, M. Kumi Smith, Hongyun Fu, Michael Marks, Juan Nie, Heping Zheng, Joseph D Tucker, Bin Yang

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background
Syphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up human immunodeficiency virus (HIV) self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing.

Methods
A cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including sociodemographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing.

Results
Six hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7%) men tested for syphilis, of whom 174/699 (24.9%) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test and 161 (92.5%) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation to family or friends (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.32–2.73), reporting 2–5 male sexual partners (aOR, 1.81; 95% CI, 1.04–3.16), HIV self-testing (aOR, 39.90; 95% CI, 17.00–93.61), and never tested for syphilis in the hospital (aOR, 2.96; 95% CI, 1.86–4.72). Self-reported harms associated with syphilis self-testing were minimal.

Conclusions
Scaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV self-testing services.
Original languageEnglish
Number of pages9
JournalClinical Infectious Diseases
DOIs
Publication statusAccepted/In press - 1 Jul 2019

Cite this

Wang, Cheng ; Cheng, Weibin ; Li, Changchang ; Tang, Weiming ; Ong, Jason J. ; Smith, M. Kumi ; Fu, Hongyun ; Marks, Michael ; Nie, Juan ; Zheng, Heping ; Tucker, Joseph D ; Yang, Bin . / Syphilis self-testing : a nationwide pragmatic study among men who have sex with men in China. In: Clinical Infectious Diseases. 2019.
@article{86ba3841429d4e15b014958858e463d4,
title = "Syphilis self-testing: a nationwide pragmatic study among men who have sex with men in China",
abstract = "BackgroundSyphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up human immunodeficiency virus (HIV) self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing.MethodsA cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including sociodemographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing.ResultsSix hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7{\%}) men tested for syphilis, of whom 174/699 (24.9{\%}) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7{\%}) reported that the self-test was their first syphilis test and 161 (92.5{\%}) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation to family or friends (adjusted odds ratio [aOR], 1.90; 95{\%} confidence interval [CI], 1.32–2.73), reporting 2–5 male sexual partners (aOR, 1.81; 95{\%} CI, 1.04–3.16), HIV self-testing (aOR, 39.90; 95{\%} CI, 17.00–93.61), and never tested for syphilis in the hospital (aOR, 2.96; 95{\%} CI, 1.86–4.72). Self-reported harms associated with syphilis self-testing were minimal.ConclusionsScaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV self-testing services.",
author = "Cheng Wang and Weibin Cheng and Changchang Li and Weiming Tang and Ong, {Jason J.} and Smith, {M. Kumi} and Hongyun Fu and Michael Marks and Juan Nie and Heping Zheng and Tucker, {Joseph D} and Bin Yang",
year = "2019",
month = "7",
day = "1",
doi = "10.1093/cid/ciz603",
language = "English",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
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Wang, C, Cheng, W, Li, C, Tang, W, Ong, JJ, Smith, MK, Fu, H, Marks, M, Nie, J, Zheng, H, Tucker, JD & Yang, B 2019, 'Syphilis self-testing: a nationwide pragmatic study among men who have sex with men in China', Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciz603

Syphilis self-testing : a nationwide pragmatic study among men who have sex with men in China. / Wang, Cheng; Cheng, Weibin ; Li, Changchang; Tang, Weiming; Ong, Jason J.; Smith, M. Kumi; Fu, Hongyun; Marks, Michael; Nie, Juan ; Zheng, Heping; Tucker, Joseph D; Yang, Bin .

In: Clinical Infectious Diseases, 01.07.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Syphilis self-testing

T2 - a nationwide pragmatic study among men who have sex with men in China

AU - Wang, Cheng

AU - Cheng, Weibin

AU - Li, Changchang

AU - Tang, Weiming

AU - Ong, Jason J.

AU - Smith, M. Kumi

AU - Fu, Hongyun

AU - Marks, Michael

AU - Nie, Juan

AU - Zheng, Heping

AU - Tucker, Joseph D

AU - Yang, Bin

PY - 2019/7/1

Y1 - 2019/7/1

N2 - BackgroundSyphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up human immunodeficiency virus (HIV) self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing.MethodsA cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including sociodemographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing.ResultsSix hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7%) men tested for syphilis, of whom 174/699 (24.9%) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test and 161 (92.5%) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation to family or friends (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.32–2.73), reporting 2–5 male sexual partners (aOR, 1.81; 95% CI, 1.04–3.16), HIV self-testing (aOR, 39.90; 95% CI, 17.00–93.61), and never tested for syphilis in the hospital (aOR, 2.96; 95% CI, 1.86–4.72). Self-reported harms associated with syphilis self-testing were minimal.ConclusionsScaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV self-testing services.

AB - BackgroundSyphilis self-testing may help expand syphilis testing among men who have sex with men (MSM). China has rapidly scaled up human immunodeficiency virus (HIV) self-testing, creating an opportunity for integrated syphilis self-testing. However, there is a limited literature on implementing syphilis self-testing.MethodsA cross-sectional online survey was conducted among Chinese MSM in 2018. Participants completed a survey instrument including sociodemographic characteristics, sexual behaviors, syphilis self-testing, and HIV self-testing history. Multivariable logistic regression was conducted to identify correlates of syphilis self-testing. We also recorded potential harms associated with syphilis self-testing.ResultsSix hundred ninety-nine MSM from 89 cities in 21 provinces in China completed the study. A total of 361/699 (51.7%) men tested for syphilis, of whom 174/699 (24.9%) men used syphilis self-testing. Among 174 who had self-tested, 90 (51.7%) reported that the self-test was their first syphilis test and 161 (92.5%) reported that they undertook syphilis self-testing together with HIV self-testing. After adjusting for covariates, syphilis self-testing was correlated with disclosure of sexual orientation to family or friends (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.32–2.73), reporting 2–5 male sexual partners (aOR, 1.81; 95% CI, 1.04–3.16), HIV self-testing (aOR, 39.90; 95% CI, 17.00–93.61), and never tested for syphilis in the hospital (aOR, 2.96; 95% CI, 1.86–4.72). Self-reported harms associated with syphilis self-testing were minimal.ConclusionsScaling up syphilis self-testing could complement facility-based testing in China among MSM. Self-testing may increase first-time testing and has limited harms. Our findings suggest that syphilis self-testing could be integrated into HIV self-testing services.

U2 - 10.1093/cid/ciz603

DO - 10.1093/cid/ciz603

M3 - Article

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

ER -