{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:03:23Z","timestamp":1761512603338,"version":"build-2065373602"},"reference-count":53,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":5119,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,4,13]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The number of incident infections of syphilis and HIV have increased over the past decade across Australia, particularly among gay men. In other industrialised settings, syphilis epidemics have also resurged coincidentally with increases in HIV diagnoses. Sexually transmissible infections (STI) are a biologically plausible cofactor for increasing HIV transmission. We pose the question: could strategies purely targeting syphilis also have an indirect impact on HIV incidence? Methods: We developed an agent-based computer model that simulates the transmission and disease progression of HIV and syphilis among a population of sexually active gay men, calibrated to reflect the epidemics in Victoria, Australia. The model was informed by detailed behavioural data from a variety of sources and was used to investigate the potential epidemiological impact of different public health interventions. Results: Assuming that syphilis could act as a biological cofactor for HIV transmission, from no effect to increasing risk by five-fold, our model indicates that if Australia\u2019s syphilis action plan is effectively implemented then the number of HIV infections could decrease by up to 48% over the next decade in the absence of any specific HIV interventions. Conclusion: It is plausible that effective implementation of interventions targeting syphilis epidemics can have an indirect effect of mitigating the spread of HIV. The possible effects of STI should be considered in the design, implementation and evaluation of public health strategies and programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh10145","type":"journal-article","created":{"date-parts":[[2012,1,23]],"date-time":"2012-01-23T21:49:30Z","timestamp":1327355370000},"page":"144-151","source":"Crossref","is-referenced-by-count":10,"title":["Could implementation of Australia\u2019s National Gay Men\u2019s Syphilis Action Plan have an indirect effect on the HIV epidemic?"],"prefix":"10.1071","volume":"9","author":[{"given":"Alexander","family":"Hoare","sequence":"first","affiliation":[{"name":"ANational Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW 2010, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard T.","family":"Gray","sequence":"additional","affiliation":[{"name":"ANational Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW 2010, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P.","family":"Wilson","sequence":"additional","affiliation":[{"name":"ANational Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW 2010, Australia."},{"name":"BCorresponding author. Email: dwilson@nchecr.unsw.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2011,8,24]]},"reference":[{"key":"2025102617000422500_R1","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1097\/OLQ.0b013e318186debb","article-title":"High incidence of asymptomatic syphilis in HIV-infected MSM justifies routine screening.","volume":"36","author":"Branger","year":"2009","journal-title":"Sex Transm Dis"},{"key":"2025102617000422500_R2","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.2105\/AJPH.92.9.1387-a","article-title":"Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex with men: San Francisco, California, 1999\u20132001, USA.","volume":"92","author":"Chen","year":"2002","journal-title":"Am J Public Health"},{"key":"2025102617000422500_R3","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1016\/j.idc.2005.04.004","article-title":"Increasing rates of sexually transmitted diseases in homosexual men in Western Europe and the United States: why?","volume":"19","author":"Fenton","year":"2005","journal-title":"Infect Dis Clin North Am"},{"key":"2025102617000422500_R4","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1111\/j.1467-842X.2005.tb00215.x","article-title":"The re-emergence of syphilis among homosexually active men in Melbourne.","volume":"29","author":"Lee","year":"2005","journal-title":"Aust N Z J Public Health"},{"key":"2025102617000422500_R5"},{"key":"2025102617000422500_R6","doi-asserted-by":"publisher","first-page":"2309","DOI":"10.1097\/QAD.0b013e3282ef9fed","article-title":"Serological testing algorithm shows rising HIV incidence in a UK cohort of men who have sex with men: 10 years application.","volume":"21","author":"Fisher","year":"2007","journal-title":"AIDS"},{"key":"2025102617000422500_R7","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1071\/SH07075","article-title":"Trends in HIV incidence in homosexual men in developed countries.","volume":"5","author":"Grulich","year":"2008","journal-title":"Sex Health"},{"key":"2025102617000422500_R8"},{"key":"2025102617000422500_R9"},{"key":"2025102617000422500_R10"},{"key":"2025102617000422500_R11"},{"key":"2025102617000422500_R12","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1136\/sti.2004.013094","article-title":"Seroprevalence of and risk factors for HIV-1 infection among South American men who have sex with men.","volume":"80","author":"Bautista","year":"2004","journal-title":"Sex Transm Infect"},{"key":"2025102617000422500_R13","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/sti.75.1.3","article-title":"From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection.","volume":"75","author":"Fleming","year":"1999","journal-title":"Sex Transm Infect"},{"key":"2025102617000422500_R14","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1038\/nrmicro794","article-title":"The role of sexually transmitted diseases in HIV transmission.","volume":"2","author":"Galvin","year":"2004","journal-title":"Nat Rev Microbiol"},{"key":"2025102617000422500_R15","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1136\/bmj.298.6674.623","article-title":"Genital ulcers, other sexually transmitted diseases, and the sexual transmission of HIV.","volume":"298","author":"Piot","year":"1989","journal-title":"BMJ"},{"key":"2025102617000422500_R16","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1071\/SH06043","article-title":"Risk factors for incident HIV infection in men having sex with men: a case\u2013control study.","volume":"4","author":"Read","year":"2007","journal-title":"Sex Health"},{"key":"2025102617000422500_R17","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1097\/00007435-200110000-00005","article-title":"A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known?","volume":"28","author":"Rottingen","year":"2001","journal-title":"Sex Transm Dis"},{"key":"2025102617000422500_R18","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1056\/NEJM198808043190504","article-title":"Human immunodeficiency virus infection among men with sexually transmitted diseases. 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