Since 2010, there has been a 4-fold increase in the number of cases of syphilis diagnosed in BC. gbMSM, specifically HIV-positive gbMSM, have carried the disproportionate burden of this epidemic. This is concerning as syphilis enhances the transmission of HIV, and people living with HIV are at higher risk of complications and more severe disease.Other bacterial sexually transmitted infections (STIs) are also more prevalent in the gbMSM population, and similarly enhance HIV transmission.
The environment for gbMSM has shifted significantly within the last two decades, with the advent of new drugs (from life-saving HIV medication to more recent HIV pre-exposure prophylaxis) combined with changes in how gbMSM meet sexual partners. Additionally, gbMSM may be adapting their sexual behaviours to reduce their risk of HIV transmission, such as substituting oral sex for anal sex or choosing partners with the same HIV status, which have impacts on risk of STIs. Research has not kept pace with these changes, providing a need for a qualitative research study to understand the current landscape for gbMSM.
As part of a larger project, researchers at the BC Centre for Disease Control (BCCDC) plan to test the efficacy of daily doxycycline to prevent new syphilis infections, and its safety and tolerability. While the biomedical aspect of the project is key, the team would focus on examining the further upstream determinants of health associated with syphilis infection in gbMSM.