A2d Self and Partner Examination for Syphilis Symptoms Among HIV-Infected Men Who Have Sex with Men — Phoenix, Arizona, 2008–2009

Tuesday, March 9, 2010: 11:00 AM
Cottonwood (M1) (Omni Hotel)
Brandy Peterson, MPH, CHES1, Melanie Taylor, MD, MPH2, John Post, MD3, Thanes Vanig, MD4 and Carol Williams, FNP4, 1Office of Workforce and Career Development/Public Health Prevention Service, Centers for Disease Control and Prevention, Atlanta, GA, 2Office of HIV, STD, and Hepatitis Services, Arizona Department of Health Services, Phoenix, AZ, 3McDowell Healthcare Center, Maricopa Integrated Health System, Phoenix, AZ, 4Spectrum Medical Group, P.C, Phoenix, AZ

Background: Syphilis infection among men who have sex with men (MSM) has been characterized by high rates of HIV coinfection (range: 20%–70%). In Arizona in 2008, MSM accounted for 80% of all Maricopa County male primary and secondary syphilis cases. Examination of self and sexual partners for syphilis lesions can lead to earlier diagnosis, treatment, and partner referral among HIV-infected MSM.

Objectives: To increase self and partner examination of oral, penile, and rectal areas for syphilis lesions though an educational intervention during HIV clinic visits.

Methods: During February 2, 2008–January 31, 2009, at each visit, all male patients from two HIV clinics in Phoenix received a handout that contained educational statements and photos of syphilis lesions. At the end of the visit, these patients completed a self-administered questionnaire to assess their frequency of self and partner examination for syphilis lesions during the previous 3 months.

Results: 1,817 questionnaires were received, of which 1,633 completed questionnaires were from male patients (76% MSM) at one or more visits to the HIV clinics. Data were analyzed by using SPSS®. Between baseline and intervention completion, the number of patients who reported never checking their mouth decreased from 46.3% to 17.2% (P = <.001); their penis from 30.5% to 7.3% (P = <.001); and their rectal area from 49.3% to 18.4% (P = <.001). Similarly, the number of patients who reported never checking their partner’s mouth decreased from 62.4% to 26.6% (P = <.001); their partner’s penis 47.2% to 13.3% (P = <.001); and their partner’s rectal area from 52.2% to 17.8% (P = <.001).

Conclusions: After reviewing syphilis educational photos, more HIV-infected men at two HIV clinics reported examining themselves or their partners for syphilis lesions.

Implications for Programs, Policy, and/or Research: Patient education regarding syphilis should include recommendations for self and partner examination to identify syphilis lesions and help prevent spread of the disease.