Online-Mediated Syphilis Testing Shows Promise

Online-mediated syphilis testing is helping diagnose syphilis among men who have sex with men (MSM), a new report suggests.

The annual number of syphilis cases in Amsterdam increased from 35 to 240 between 1998 and 2004, according to Rik H. Koekenbier of GGD Amsterdam and colleagues. Infections among MSM amounted to 84 percent of new syphilis diagnoses in 2004.

The researchers developed a Web site that offered information about syphilis and motivated visitors to download a referral letter linking them to syphilis testing in a nonclinical setting. One week after undergoing a blood test, participants could view their results online. The researchers compared the percentage of syphilis-infected men detected online with those diagnosed at the local STD clinic during the same time period.

During 15 months, 898 site visitors downloaded referral letters, and 93 men (10 percent) were tested. The online results feature was used by 90 of the 93 men (96 percent). Of the 93 men tested, 14 (15 percent) had a positive test. Four of these did not confirm their results at the STD clinic. Of the 10 infected men who visited the STD clinic, three (33 percent) had never done so before. A "significantly higher percentage" of men needing treatment for syphilis were found through the Web site compared with the STD clinic (50 percent vs. 24 percent).

"Online-mediated testing for syphilis is feasible and was more successful in detecting [MSM] with an early or late syphilis infection than standard procedures," the authors concluded. "However, longer promotion periods are needed to generate more usage of the online service."

"The more people come in contact with online public health interventions, the better our chances are of improving the health of the population," said Koekenbier. "In this time where people receive and process information from different technical platforms such as mail, chat and Web sites, it becomes more important to be exposed on all these platforms."

The report, "Online-Mediated Syphilis Testing: Feasibility, Efficiency, and Usage," was published in Sexually Transmitted Diseases (2008;35(8):764-769).

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