Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;46(1):22-30.
doi: 10.1007/s10900-020-00834-8.

An Investigation of Early Syphilis Among Men Who have Sex with Men: Alaska, 2018: Findings from a 2018 Rapid Ethnographic Assessment

Penny S Loosier  1 , Monique Carry  2 , Amy Fasula  3 , Kendra Hatfield-Timajchy  3 , Susan A Jones  4 , Jessica Harvill  4 , Tracy Smith  4 , Joseph McLaughlin  4
Affiliations

An Investigation of Early Syphilis Among Men Who have Sex with Men: Alaska, 2018: Findings from a 2018 Rapid Ethnographic Assessment

Penny S Loosier et al. J Community Health. 2021 Feb.

Abstract

The state of Alaska had a sharp increase in cases of primary and secondary syphilis among gay, bisexual, and other men who have sex with men (GBMSM) in 2018, centered in Anchorage. A rapid ethnographic assessment was conducted in October 2018 to examine contextual factors contributing to local increases in syphilis. The assessment team conducted qualitative interviews with 64 (N=49 interviews) key informants in Anchorage and Matanuska-Susitna Valley identified through the STD/HIV program at the Alaska Department of Health and Social Services, Division of Public Health (ADPH): ADPH staff (n = 11; 22%) Medical Providers (n = 18; 37%), Community-Based Organizations/Partners (n = 9; 18%), and GBMSM Community Members (n = 11; 22%). This project was deemed exempt from IRB review. Primary factors affecting syphilis transmission, care, and treatment among GBMSM were: (1) Low awareness about the current syphilis outbreak and ambivalence about syphilis and other STIs; (2) Aspects of sexual partnering such as travel, tourism, and the use of online sites and apps to facilitate anonymous sex and multiple (both sequential/concurrent) partnering; (3) The synergistic effects of substance use, homelessness, and transactional sex; (4) Choosing condomless sex; and (5) Challenges accessing healthcare, including the ability to find appropriate and culturally competent care. Syphilis increases may have been influenced by factors which spanned multiple sectors of the Anchorage community, including individual behavior, community-level risk and protective factors, and use of and interactions with resources offered by ADPH, community-based organizations, and medical providers.

Keywords: Gay, bisexual and other men who have sex with men; Outbreak response; Qualitative data; Rapid ethnographic assessment; Syphilis.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest The authors have no conflicts of interest to report.

References

    1. Dombrowski JC, Pedersen R, Marra CM, Kerani RP, & Golden MR (2015). Prevalence estimates of complicated syphilis. Sexually Transmitted Diseases, 42(12), 702–704. - PubMed
    1. Woolston S, Cohen SE, Fanfair RN, Lewis SC, Marra CM, & Golden MR (2015). A cluster of ocular syphilis cases—Seattle, Washington, and San Francisco, California, 2014–2015. MMWR: Morbidity & Mortality Weekly Report, 64(40), 1150–1151. - PMC - PubMed
    1. Holmes KK, Sparling PF, Stamm WE, et al. (Eds.). (2008). Sexually transmitted diseases (4th ed.). China: The McGraw-Hill Companies.
    1. Oliver SE, Aubin M, Atwell L, et al. (2016). Ocular syphilis—Eight jurisdictions, United States, 2014–2015. MMWR: Morbidity & Mortality Weekly Report, 65(43), 1185–1188. - PubMed
    1. Centers for Disease Control and Prevention. (2007). Symptomatic early neurosyphilis among HIV-positive men who have sex with men–four cities, United States, January 2002–June 2004. MMWR—Morbidity & Mortality Weekly Report, 56(25), 625–628. - PMC - PubMed