Taming the great: enhanced syphilis screening in HIV-positive men who have sex with men in a hospital clinic setting.

Syphilis incidence in HIV-positive men who have sex with men (MSM) continues to increase, with strategies based on early detection and treatment urgently required to control rising infections. There are barriers to enhanced testing in certain settings. At our tertiary referral HIV centre, testing rates before and after a period of enhanced syphilis testing in HIV-positive MSM were assessed. When compared with the control period (pre-enhanced screening), the enhanced syphilis testing was associated with a significant increase in syphilis testing of HIV-positive patients undergoing routine viral load testing (136 out of 574, 23% vs 317 out of 574, 55%; P<0.0001) and a three-fold increase in new syphilis diagnoses (4 out of 574 vs 18 out of 574, P=0.004).