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Background: Current screening recommendations state that men who have sex with men (MSM) should be screened annually for syphilis and for rectal gonorrhea if they have receptive anal intercourse. As part of a Centers for Disease Control and Prevention Targeted Evaluation Plan, the Illinois Department of Public Health STD Program collaborated with Howard Brown Health (HBH) to increase annual syphilis and rectal gonorrhea screening among MSM.
Methods: We surveyed ten primary health care providers at HBH to determine facilitators and barriers to annual screening for syphilis and rectal gonorrhea in MSM clients. Qualitative analyses of survey results were performed to identify common themes. HBH staff presented screening recommendations and screening data to providers at staff meetings. Descriptive statistics were used to compare screening data among gay, bisexual, and queer (GBQ) cis-men from 2014 compared to 2015.
Results: From the survey we found that 50.0% of providers suggested adding a prompt in their electronic medical record system or include syphilis screening when ordering annual labs to increase annual syphilis screening. Providers stated the best ways to increase annual rectal gonorrhea screening were to educate patients about rectal testing and to have better methods to ask patients about their sexual practices (n=5). Other low cost solutions were found to increase screening practices. There was a 20.2% increase in GBQ cis-men that were seen at HBH from 2014 to 2015 (n=4,086 and n=4,911). Screening increased from 2014 to 2015 for both annual syphilis (61.6% to 73.7%) and annual rectal gonorrhea (29.2% to 46.0%).
Conclusions: An increase in annual syphilis and rectal gonorrhea screening among MSM at HBH occurred from 2014 to 2015. Several factors may have contributed to this increase including the administration of a survey that identified ways to improve annual screening and raised awareness of current screening data at HBH.