The Development of Australia’s National Syphilis Action Plan is Based in Interdisciplinary Research Findings

By Garrett Prestage, Richard Gray, Ian Down, Alexander Hoare, Pol Dominic McCann and David Wilson.

Published by The Social Sciences Collection

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Article: Print $US10.00
Article: Electronic $US5.00

Background: The Australian HIV ‘partnership model’ brings together government, community, clinicians and researchers across multiple disciplines including social, epidemiological, surveillance, and modelling to work together to inform each other on the best public health responses. This same model was used to establish the National Syphilis Action Plan (NSAP) in response to a resurgent syphilis epidemic among gay men.
Methods: We combined mathematical modelling with quantitative and qualitative social research to explore the feasibility of different interventions (partner reduction, increased condom use, increased testing frequency, mass treatment, improved partner notification, and chemoprophylaxis) to reduce rates of syphilis. We conducted online surveys and focus groups to determine whether such interventions were likely to be acceptable to Australian gay men and we developed a mathematical transmission model that simulated sexually activity and transmission among a population of sexually active gay men to explore the potential epidemiological impact of each intervention.
Results: The modelling demonstrated that changes in sexual behaviour (reducing sexual partner acquisition or increasing condom usage) are only likely to be effective if such changes are maintained indefinitely, and the social research data indicated such changes were not uniformly acceptable, particularly to gay men at higher risk and not as a long-term strategy. In contrast, increasing rates of testing for syphilis and partner notification were simulated to produce large reductions in syphilis infections and they were also broadly acceptable to all gay men. Use of chemoprophylaxis also appeared to be an effective strategy that had broad acceptance to gay men. Based on this interdisciplinary research and engagement with partners in the sector, target goals were set for Australia’s NSAP.
Conclusions: Our interdisciplinary approach demonstrated which interventions may be effective and acceptable in reducing syphilis infections within the target population. Interdisciplinary research can account for multiple factors to mutually inform public health programs.

Keywords: Modelling, Survey, Qualitative Research, Syphilis, Public Health, Gay Men, Australia

International Journal of Interdisciplinary Social Sciences, Volume 5, Issue 11, pp.239-262. Article: Print (Spiral Bound). Article: Electronic (PDF File; 961.053KB).

Assoc. Prof. Garrett Prestage

Associate Professor, 1. National Centre in HIV Epidemiology and Clinical Research, 2. Australian Research Centre in Sex Health and Society, The University of New South Wales, NSW, Australia, and La Trobe University, Sydney, Victoria, Australia

Garrett Prestage works for Australia’s National Centre in HIV Epidemiology and Clinical Research for the Australian Research Centre in Sex Health and Society. He has an extensive body of social and behavioural research on HIV, gay men, risk, and sexual practices and sexual health using both quantitative and qualitative research methods. His achievements include several large cohort studies of gay men, such as Sydney Men and Sexual Health (1993-1997), Positive Health (1998-2007), and Health in Men (2001-2007). He works within a community-oriented framework and his work has influenced social policy and educational practice, as well as research methodology among gay men.

Richard Gray

National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, Australia

Ian Down

National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, NSW, Australia, and La Trobe University, Sydney, Victoria, Australia

Alexander Hoare

National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, Australia

Pol Dominic McCann

National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, Australia

Assoc. Prof. David Wilson

Head of the Surveillance and Evaluation Program for Public Health, National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, Australia

Associate Professor David Wilson is Head of the Surveillance and Evaluation Program for Public Health at the National Centre in HIV Epidemiology and Clinical Research, University of New South Wales. He coordinates Australia’s national surveillance system for monitoring numbers of diagnoses of HIV, viral hepatitis, and specific sexually transmissible infections in Australia. He is also an international leader in mathematical modeling of infectious diseases in order to understand key drivers of epidemics, explain past trends, and forecast the future trajectories of HIV, viral hepatitis and STI epidemics under different intervention strategies in Australia and Southeast Asia. In this capacity he monitors and evaluates epidemic trends and programs in order to inform public health responses.

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