Abstract
Objectives
Syphilis rates have increased in BC and disproportionately affect gay, bisexual, and other men who have sex with men (gbMSM). A social marketing campaign (Syphistory) ran from January to September 2017 with the primary goal of increasing syphilis knowledge and a secondary goal of increasing syphilis screening among gbMSM in BC.
Methods
We used pre- and post-campaign surveys to assess changes in syphilis knowledge from a convenience sample of clients attending STI clinics using one-sided t-tests. We used online Piwik metrics to examine the campaign reach, and provincial testing data to examine trends in syphilis screening. We used data from the Engage Study to examine factors associated with campaign awareness and associations with syphilis testing.
Results
Of the 2155 visitors to the Syphistory website with known geography, 79.4% were from BC. Moreover, STI clinic participants who saw the campaign demonstrated a greater knowledge of syphilis (9.7/12, 80.8%) than those who did not see the campaign (mean 8.9/12, 74%) (p < 0.001). Provincial syphilis testing rates were 8764 and 9749 in the 12 months before and after the campaign; however, we did not find an overall trend in testing before versus after the campaign (p = 0.147). Among Engage participants, 12.7% reported seeing the campaign and we found an association between campaign exposure and recent syphilis testing (aOR = 2.73; 95% CI = 1.51, 4.93).
Conclusion
gbMSM who saw the campaign were more likely to report being tested for syphilis in the previous 6 months. STI clinic attendees who reported seeing the campaign also had higher syphilis knowledge compared to those who did not.
Résumé
Objectifs
Les taux de syphilis ont augmenté en Colombie-Britannique et affectent de manière disproportionnée les hommes gais, bisexuels et autres hommes ayant des relations sexuelles avec des hommes (gbHARSAH). Une campagne de marketing social (Syphistory) a été mené de janvier à septembre 2017 avec pour objectif principal d’informer sur la syphilis et pour objectif secondaire d’augmenter le dépistage de la syphilis chez les gbHARSAH en Colombie-Britannique.
Méthodes
Nous avons réalisé deux sondages, l’un avant et l’autre après la campagne, sur un échantillon de convenance constitué de patients fréquentant des cliniques ITS, pour évaluer les changements dans les connaissances sur la syphilis à l’aide de tests t unilatéraux. Nous avons utilisé les mesures Piwik en ligne pour examiner la portée de la campagne et les données provinciales sur les tests pour examiner les tendances quant au dépistage de la syphilis. Nous avons utilisé les données de l’étude Engage à Vancouver, pour identifier les facteurs associés à la sensibilisation lors de la campagne et les associations avec le dépistage de la syphilis.
Résultats
Sur les 2 155 visiteurs du site Web Syphistory dont la position géographique était connue, 79,4 % provenaient de la Colombie-Britannique. De plus, les participants aux cliniques ITS ayant vu la campagne ont démontré une meilleure connaissance de la syphilis (9,7/12, 80,8 %) par rapport à ceux n’ayant pas vu la campagne (moyenne 8,9/12, 74 %) (p<0,001). Les taux provinciaux de dépistage de la syphilis étaient de 8 764 et 9 749 au cours des 12 mois précédant et suivant la campagne; cependant, nous n’avons pas trouvé de tendance globale à la hausse des dépistages suite à la campagne (p=0,147). Parmi les participants Engage, 12,7 % ont déclaré avoir vu la campagne en ligne et nous avons trouvé une association entre l’exposition à la campagne et le dépistage récent de la syphilis (RCa=2,73; IC à 95 %=1,51, 4,93).
Conclusion
Les gbHARSAH qui ont vu la campagne étaient plus susceptibles de déclarer avoir été testés pour la syphilis au cours des six derniers mois. Les participants aux cliniques ITS qui ont déclaré avoir vu la campagne avaient également une meilleure connaissance de la syphilis que ceux qui ne l’ont pas vue.
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Data availability
Deidentified participant data used in this analysis are stored at the BC CDC and the BC CfE.
Code availability
Access to the data and code are available on request.
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Acknowledgements
We would like to thank the BCCDC Public Health Laboratory, BCCDC STI clinic, and Health Initiative for Men for distributing the Syphistory survey, and most importantly, the Syphistory survey participants. We would also like to thank the Engage Study participants, office staff, and community advisory board as well as our community partners: Health Initiative for Men, YouthCO HIV & Hep C Society, and Positive Living Society of BC.
Funding
This work was supported by the Canadian Institutes of Health Research (TE2-138299, FDN-143342, PJT-153139), the Canadian Association for HIV/AIDS Research (CANFAR, #Engage), the Ontario HIV Treatment Network (OHTN, #1051), and the Public Health Agency of Canada (#4500345082). JMS is supported by a CTN Postdoctoral Fellowship Award and Michael Smith Foundation for Health Research Trainee award. NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. DMM and NJL are supported by Michael Smith Foundation for Health Research Scholar Awards (#5209, #16863). DG is supported by a Canada Research Chair in Sexual and Gender Minority Health.
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Authors and Affiliations
Contributions
Jordan Sang led manuscript writing, analysis consultation, and manuscript preparation. Jason Wong conceived the research idea, led the campaign, led the preliminary analyses, provided consultation, and provided feedback for the manuscript. Venessa Ryan conducted analyses and provided feedback for the manuscript. Emma Cumming assisted with analyses. Lu Wang and Zishan Cui assisted with analyses and provided feedback for the manuscript. Nicanor Bacani assisted in data cleaning for the data. Devon Haag supported the campaign and assisted with analyses. Nathan Lachowsky, Joseph Cox, and Daniel Grace are principal investigators for Engage and provided feedback for the manuscript. Michael Otterstatter provided consultation for the analyses. Muhammad Moshed provided expertise for syphilis testing. Joshua Edward led the survey evaluation with community organizations. Troy Grennan led the campaign and provided consultation for the manuscript. Jillian Arkles and Bobbi Brownrigg supported the campaign. Robert S. Hogg is a principal investigator for the Momentum Study. David Moore is a principal investigator for Engage, oversaw analyses, and provided feedback for the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committees (McGill University Health Centre REB# 15-623-MUHC; Ryerson University REB# 2016-113; University of Toronto REB# 00033527; St. Michael’s Hospital REB# 17-043; University of Windsor REB# 16-180; University of British Columbia REB# H16-01226) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Sang, J.M., Wong, J., Ryan, V. et al. Examining the impacts of a syphilis awareness campaign among gay, bisexual, and other men who have sex with men (gbMSM) in British Columbia, Canada. Can J Public Health 114, 295–307 (2023). https://doi.org/10.17269/s41997-022-00690-0
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DOI: https://doi.org/10.17269/s41997-022-00690-0