title: Automated, computer generated reminders and increased detection of gonorrhoea, chlamydia and syphilis in men who have sex with men.
abstract: BACKGROUND
  Guidelines recommend frequent screening of men who have sex with men (MSM) for sexually transmissible infections (STIs) but few interventions have demonstrated increased testing and detection of bacterial STIs among MSM in controlled studies.
  
  
  METHODS
  We used automated text message and email reminders generated by computer assisted self-interview (CASI) to remind MSM to retest for syphilis. We compared clinic visits, STI testing and detection rates over 12 month between men receiving reminders (reminder group) and men not offered the reminders (concurrent control group).
  
  
  RESULTS
  Men who chose 3-monthly reminders had more clinic visits (median 3 vs 1) and higher testing rates for pharyngeal gonorrhoea (67.0% vs 33.6%), rectal gonorrhoea (62.7% vs 31.1%), urethral chlamydia (67.3% vs 39.3%), rectal chlamydia (62.9% vs 31.3%), syphilis (67.0% vs 39.3%) and HIV (64.9% vs 36.7%) (all p<0.001) than concurrent controls, within 12 months after their first visit. Also, men receiving reminders had a higher combined testing rate for all the aforementioned STIs at a same visit (55.7% vs 25.5%, p<0.001) compared with concurrent controls. This association remained after adjusting for differences in characteristics between the two groups (adjusted odds ratio:1.77, 95% confidence interval:1.51-2.08). Men receiving reminders also had a higher detection rate of: rectal gonorrhoea (3.7% vs 1.2%, p = 0.001), urethral chlamydia (3.1% vs 1.4%, p = 0.027), rectal chlamydia (6.6% vs 2.8%, p<0.001), and early, latent syphilis (1.7% vs 0.4%, p = 0.008) compared with concurrent controls.
  
  
  CONCLUSIONS
  This is the first study to demonstate that a fully automated reminder system using CASI was associated with increased detection of bacterial STIs among MSM.
authors.affiliation: Sexual Health Unit, School of Population Health, University of Melbourne, Melbourne, Australia.
authors.forename: Huachun
authors.initials: H
authors.lastname: Zou
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guy
authors.forename: Jade
authors.initials: J
authors.lastname: Bilardi
authors.forename: Catriona S
authors.initials: CS
authors.lastname: Bradshaw
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Garland
authors.forename: Jun Kit
authors.initials: JK
authors.lastname: Sze
authors.forename: Afrizal
authors.initials: A
authors.lastname: Afrizal
authors.forename: Marcus Y
authors.initials: MY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001331:Automation; D016022:Case-Control Studies; D002690:Chlamydia Infections / Q000175:diagnosis*; D034742:Electronic Mail; D006069:Gonorrhea / Q000175:diagnosis*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D017010:Reminder Systems; D013587:Syphilis / Q000175:diagnosis*; D060145:Text Messaging