Evidence map›Paper›PMID 40662734›Full record

ArticleThe Journal of infectious diseases2025

Impact and Cost-effectiveness of Regular Self-digital Anorectal Examination on Syphilis Among Gay, Bisexual, and Other Men Who Have Sex With Men: A Mathematical Modeling Study.

Hao Lai, Christopher K Fairley, Rui Li, Marcus Y Chen, Eric P F Chow, Basil Donovan, Denton Callander, Rebecca Guy, Julien Tran, Ei T Aung and 2 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Hao LaiPhase I Clinical Trial Research Ward, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.ORCID 0000-0003-0277-9364
Christopher K FairleyMelbourne Sexual Health Centre, Alfred Health, Australia.
Rui LiHeidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Germany.
Marcus Y ChenMelbourne Sexual Health Centre, Alfred Health, Australia.
Eric P F ChowMelbourne Sexual Health Centre, Alfred Health, Australia.
Basil DonovanThe Kirby Institute, University of New South Wales, Sydney, Australia.
Denton CallanderThe Kirby Institute, University of New South Wales, Sydney, Australia.
Rebecca GuyThe Kirby Institute, University of New South Wales, Sydney, Australia.
Julien TranMelbourne Sexual Health Centre, Alfred Health, Australia.ORCID 0000-0003-3139-7090
Ei T AungMelbourne Sexual Health Centre, Alfred Health, Australia.ORCID 0000-0002-2560-3233
Mingwang ShenChina-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, China.
Lei ZhangPhase I Clinical Trial Research Ward, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.ORCID 0000-0003-2343-084X

Funding

Australian NHMRC Leadership Investigator GNT1172900Ministry of Science and Technology of the People's Republic of China 2022YFC2304900Ministry of Science and Technology of the People's Republic of China 2022YFC2304905National Key R&D Program of China 2022YFC2505100National Key R&D Program of China 2022YFC2505103National Natural Science Foundation of China 12171387NHMRC GNT1172873NHMRC Practitioner Fellowship GNT1154828to E. P. F. C.
6 · The paper itself

Abstract

backgroundRising syphilis incidence among Australian gay, bisexual, and other men who have sex with men (GBMSM) requires new early detection strategies. Regular self-digital anorectal examination (self-DARE) may facilitate syphilis identification, potentially reducing transmission. We evaluated its population-level impact and cost-effectiveness in controlling syphilis among Australian GBMSM.

methodsWe developed an integrated transmission-dynamic and health-economic model, calibrated with 2012-2022 Australian GBMSM data. Over a 10-year period (2025-2034), we compared the base case with two scenarios: recommending self-DARE to men with higher sexual activity ("only high group") or to all individuals ("both groups"). We assessed changes in incidence, incremental cost-effectiveness ratios (ICERs), and benefit-cost ratios.

resultsThe base case projected 110 501 new infections over 10 years. The "only high group" strategy averted 57 115 infections (51.7%) and was cost saving (negative ICER), with a benefit-cost ratio of 2.5. The "both groups" strategy averted more infections (58 216; 52.7%) but was less economically efficient (benefit-cost ratio: 1.6), though also cost-saving. Sensitivity analyses indicated that improving self-DARE sensitivity enhanced its performance.

conclusionsSelf-DARE could effectively and cost-effectively reduce syphilis among GBMSM, particularly when focused on men with higher sexual activity. Further empirical research is needed to confirm its feasibility and effectiveness.

Indexed as

Homosexuality, MaleSelf-ExaminationSexual and Gender MinoritiesSyphilisAdultAustraliaCost-Benefit AnalysisHumansIncidenceMaleModels, Theoreticalcost-effectivenessdigital anorectal examinationearly detectionmen who have sex with mensyphilis

Identifiers

PMID40662734
PMCPMC12455306

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.