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Background: Howard Brown Health Center (HBHC) identifies a substantial proportion of syphilis morbidity in Chicago. From January - October 2010, HBHC Disease Intervention Specialists (DIS) linked 33 MSM syphilis cases in a high-risk sexual network through enhanced disease intervention strategies.
Objectives: To describe demographic and behavioral risks among network cases and discuss effective strategies for disease intervention in this population.
Methods: Data from the CDC Interview Record and a local Enhanced Interview Form were entered into an MS Access database for analysis.
Results: Median age of cases was 30 years (range: 22-50). 82% were non-Hispanic white, 12% Hispanic, and 6% non-Hispanic black. All were staged as early syphilis (15% primary, 42% secondary, and 42% early latent). Twenty-three (70%) were co-infected with HIV; 5 (22%) of whom had dual HIV/syphilis diagnoses. 24% had a documented history of syphilis. Ninety-percent reported substance use during sex, including: alcohol (73%), methamphetamines (61%), and poppers (58%). Inconsistent condom use was high for both insertive (92%) and receptive (88%) anal sex. 88% reported meeting partners online and 88% had anonymous partners. One hundred fourteen partners were elicited during DIS interview yielding a partner index of 3.7. Forty-two partners were notified online: 27 were from a popular bareback website, 9 via other sex-seeking websites, and 6 via social networking sites enabling 12 of the 33 cases to be linked. Among all partners: thirty (26%) were preventively treated, fourteen (12%) were infected and brought to treatment, and nineteen (17%) were previously treated.
Conclusions: These data indicate that successful partner notification and case linkages are possible, even within high-risk sexual networks of MSM.
Implications for Programs, Policy, and Research: High rates of case-finding through internet partner notification, particularly on websites catering to bareback sex-seeking, further demonstrates the need to adapt traditional methods of partner notification.