Exploring How Epidemic Context Influences Syphilis Screening Impact: A Mathematical Modeling Study.
Adult
Bisexuality
Epidemics
Female
HIV Infections
/ epidemiology
Homosexuality, Male
Humans
Male
Mass Screening
/ statistics & numerical data
Middle Aged
Models, Theoretical
Population Surveillance
Sexual and Gender Minorities
/ statistics & numerical data
Syphilis
/ diagnosis
United States
/ epidemiology
Young Adult
Journal
Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
pubmed:
26
9
2020
medline:
1
4
2021
entrez:
25
9
2020
Statut:
ppublish
Résumé
The current syphilis epidemic in the United States is concentrated in gay, bisexual, and other men who have sex with men (MSM), but substantial heterosexual transmission is reported in some parts of the country. Using the US states of Louisiana and Massachusetts as case studies, we investigated how epidemic context influences the impact of population screening approaches for syphilis control. We constructed a compartmental metapopulation model parameterized to describe observed patterns of syphilis transmission. We estimated the impact of different approaches to screening, including perfect adherence to current US screening guidelines in MSM. In Louisiana, where syphilis cases are more evenly distributed among MSM and heterosexual populations, we projected that screening according to guidelines would contribute to no change or an increase in syphilis burden, compared with burden with current estimated screening coverage. In Massachusetts, which has a more MSM-focused outbreak, we projected that screening according to guidelines would be as or more effective than current screening coverage in most population groups. Men who have sex with men-focused approaches to screening may be insufficient for control when there is substantial transmission in heterosexual populations. Epidemic characteristics may be useful when identifying at-risk groups for syphilis screening.
Sections du résumé
BACKGROUND
The current syphilis epidemic in the United States is concentrated in gay, bisexual, and other men who have sex with men (MSM), but substantial heterosexual transmission is reported in some parts of the country. Using the US states of Louisiana and Massachusetts as case studies, we investigated how epidemic context influences the impact of population screening approaches for syphilis control.
METHODS
We constructed a compartmental metapopulation model parameterized to describe observed patterns of syphilis transmission. We estimated the impact of different approaches to screening, including perfect adherence to current US screening guidelines in MSM.
RESULTS
In Louisiana, where syphilis cases are more evenly distributed among MSM and heterosexual populations, we projected that screening according to guidelines would contribute to no change or an increase in syphilis burden, compared with burden with current estimated screening coverage. In Massachusetts, which has a more MSM-focused outbreak, we projected that screening according to guidelines would be as or more effective than current screening coverage in most population groups.
CONCLUSIONS
Men who have sex with men-focused approaches to screening may be insufficient for control when there is substantial transmission in heterosexual populations. Epidemic characteristics may be useful when identifying at-risk groups for syphilis screening.
Identifiants
pubmed: 32976353
doi: 10.1097/OLQ.0000000000001249
pmc: PMC7668348
pii: 00007435-202012000-00003
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
798-810Subventions
Organisme : NCHHSTP CDC HHS
ID : U38 PS004644
Pays : United States
Références
Sex Health. 2019 Jun;16(3):254-262
pubmed: 31142431
Sex Transm Infect. 2015 Feb;91(1):70-1
pubmed: 25609470
Sex Transm Infect. 2005 Jun;81(3):217-9
pubmed: 15923288
Lancet. 2003 Jan 25;361(9354):313-4
pubmed: 12559870
J Chronic Dis. 1955 Sep;2(3):311-44
pubmed: 13252075
MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137
pubmed: 26042815
PLoS One. 2013 Aug 23;8(8):e71436
pubmed: 24009661
Sex Transm Dis. 1997 Apr;24(4):185-200
pubmed: 9101629
Sex Transm Infect. 2018 Mar;94(2):105-110
pubmed: 28705938
Lancet Infect Dis. 2008 Sep;8(9):577-81
pubmed: 18718441
Sex Transm Dis. 2010 May;37(5):298-305
pubmed: 20393383
JAMA. 2016 Jun 07;315(21):2321-7
pubmed: 27272583
BMC Public Health. 2013 Jun 24;13:606
pubmed: 23800206
JAMA. 2018 Sep 4;320(9):911-917
pubmed: 30193283
JMIR Public Health Surveill. 2016 Apr 21;2(1):e14
pubmed: 27227149
Sex Transm Dis. 2018 Sep;45(9S Suppl 1):S20-S22
pubmed: 29538279
Sex Transm Dis. 2013 Apr;40(4):338-40
pubmed: 23486501
Sex Transm Infect. 2016 Feb;92(1):49-54
pubmed: 25954016
J Acquir Immune Defic Syndr. 2010 Oct;55(2):211-6
pubmed: 20585261
Expert Rev Anti Infect Ther. 2015 Feb;13(2):161-8
pubmed: 25487961
Sex Transm Dis. 2016 Jul;43(7):429-32
pubmed: 27322043
Medicine (Baltimore). 1956 Feb;35(1):33-82
pubmed: 13296652
Int J STD AIDS. 2017 Jan;28(1):77-87
pubmed: 26769755
Sci Rep. 2017 Jul 25;7(1):6464
pubmed: 28743879
PLoS One. 2014 Jul 01;9(7):e101240
pubmed: 24983455