{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:57:47Z","timestamp":1782979067393,"version":"3.54.5"},"reference-count":26,"publisher":"CSIRO Publishing","issue":"6","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":608,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/T003995\/1"],"award-info":[{"award-number":["MR\/T003995\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Access to syphilis testing and treatment is frequently limited for men who have sex with men (MSM). A two-armed randomised controlled trial compared feasibility and costs of facility-based syphilis testing with self-testing among MSM in Zimbabwe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This randomised controlled trial was conducted in Harare, with participants randomised 1:1. Syphilis self-testing was offered in community-based settings. The primary outcome was the relative proportion of individuals taking up testing. Total incremental economic provider and user costs, and cost per client tested, diagnosed and treated were assessed using ingredients-based costing in 2020\u00a0US$.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 100 men were enrolled. The two groups were similar in demographics. The mean age was 26\u00a0years. Overall, 58% (29\/50) and 74% (37\/50) of facility- and self-testing arm participants, respectively, completed syphilis testing. A total of 28% of facility arm participants had a reactive test, with 50% of them returning for confirmatory testing yielding 28% reactivity. In the self-testing arm, 67% returned for confirmatory testing, with a reactivity of 16%. Total provider costs were US$859 and US$736, and cost per test US$30 and US$15 for respective arms. Cost per reactive test was US$107 and US$123, and per client treated US$215 and US$184, respectively. The syphilis test kit was the largest cost component. Total user cost per client per visit was US$9.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Syphilis self-testing may increase test uptake among MSM in Zimbabwe. However, some barriers limit uptake including lack of self-testing and poor service access. Bringing syphilis testing services to communities, simplifying service delivery and increasing self-testing access through community-based organisations are useful strategies to promote health-seeking behaviours among MSM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh23038","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T19:32:21Z","timestamp":1693855941000},"page":"514-522","source":"Crossref","is-referenced-by-count":5,"title":["Feasibility and economic costs of syphilis self-testing to expand test uptake among gay, bisexual and transgender men: results from a randomised controlled trial in Zimbabwe"],"prefix":"10.1071","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6058-5237","authenticated-orcid":true,"given":"Definate","family":"Nhamo","sequence":"first","affiliation":[{"name":"APangaea Zimbabwe AIDS Trust (PZAT), Harare, Zimbabwe."},{"name":"BDepartment of Nursing and Public Health, University of KwaZulu Natal (UKZN), Durban, South Africa."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collin","family":"Mangenah","sequence":"additional","affiliation":[{"name":"CCentre for Sexual Health and HIV Research (CeSHHAR), Harare, Zimbabwe."},{"name":"DDepartment of International Global Public Health, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwendoline","family":"Chapwanya","sequence":"additional","affiliation":[{"name":"APangaea Zimbabwe AIDS Trust (PZAT), Harare, Zimbabwe."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takudzwa","family":"Mamvuto","sequence":"additional","affiliation":[{"name":"APangaea Zimbabwe AIDS Trust (PZAT), Harare, Zimbabwe."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imelda","family":"Mahaka","sequence":"additional","affiliation":[{"name":"APangaea Zimbabwe AIDS Trust (PZAT), Harare, Zimbabwe."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarisse","family":"Sri-Pathmanathan","sequence":"additional","affiliation":[{"name":"EDepartment of Clinical Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashida A.","family":"Ferrand","sequence":"additional","affiliation":[{"name":"EDepartment of Clinical Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK."},{"name":"FBiomedical Research and Training Institute, Harare, Zimbabwe."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Kranzer","sequence":"additional","affiliation":[{"name":"EDepartment of Clinical Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK."},{"name":"FBiomedical Research and Training Institute, Harare, Zimbabwe."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1693-5196","authenticated-orcid":true,"given":"Fern","family":"Terris-Prestholt","sequence":"additional","affiliation":[{"name":"GDepartment of Global Health and Development, London School of Hygiene and Tropical Medicine (LSHTM), London, UK."},{"name":"HUNAIDS, Joint United Nations Programme on HIV\/AIDS, Geneva, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Marks","sequence":"additional","affiliation":[{"name":"EDepartment of Clinical Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2804-1181","authenticated-orcid":true,"given":"Joseph D.","family":"Tucker","sequence":"additional","affiliation":[{"name":"EDepartment of Clinical Research, London School of Hygiene and Tropical Medicine (LSHTM), London, UK."},{"name":"IInstitute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill (UNC), Chapel Hill, NC, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2023,9,5]]},"reference":[{"key":"2025111812583609100_R1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056713","article-title":"Early antenatal care: does it make a difference to outcomes of pregnancy associated with syphilis? 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