title: Duration of syphilis symptoms at presentations in men who have sex with men in Australia: are current public health campaigns effective?
abstract: The rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007-2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6-14] days and 14 (IQR 7-30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64-256) was higher than in primary syphilis (median 4, IQR 1-32) and in early latent syphilis (median 32, IQR 4-64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: E P F
authors.initials: EP
authors.lastname: Chow
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: K
authors.initials: K
authors.lastname: Dutt
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: G
authors.initials: G
authors.lastname: Fehler
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: I
authors.initials: I
authors.lastname: Denham
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: M Y
authors.initials: MY
authors.lastname: Chen
authors.affiliation: Victorian AIDS Council/Gay Men's Health Centre,Melbourne,VIC,Australia.
authors.forename: C
authors.initials: C
authors.lastname: Batrouney
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: J
authors.initials: J
authors.lastname: Peel
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: T R H
authors.initials: TR
authors.lastname: Read
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: C S
authors.initials: CS
authors.lastname: Bradshaw
authors.affiliation: Melbourne Sexual Health Centre,Alfred Health,Melbourne,VIC,Australia.
authors.forename: C K
authors.initials: CK
authors.lastname: Fairley
mesh_terms: D000328:Adult; D000372:Agglutination Tests; D001315:Australia / Q000453:epidemiology; D006293:Health Promotion; D018451:Homosexuality, Male; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D011935:Reagins / Q000097:blood*; D012725:Sexual Behavior; D013587:Syphilis / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D013997:Time Factors; D014210:Treponema pallidum / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D011935:Reagins
keywords: Men who have sex with men; public health; symptoms recognition; syphilis