{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:03:55Z","timestamp":1785546235459,"version":"3.56.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["2022YFC2304900"],"award-info":[{"award-number":["2022YFC2304900"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["2022YFC2304905"],"award-info":[{"award-number":["2022YFC2304905"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"publisher","award":["2022YFC2505100"],"award-info":[{"award-number":["2022YFC2505100"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"publisher","award":["2022YFC2505103"],"award-info":[{"award-number":["2022YFC2505103"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key R&D Program of China","doi-asserted-by":"publisher","award":["2022YFC2505100"],"award-info":[{"award-number":["2022YFC2505100"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12171387"],"award-info":[{"award-number":["12171387"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Australian NHMRC Leadership Investigator","award":["GNT1172900"],"award-info":[{"award-number":["GNT1172900"]}]},{"name":"NHMRC Practitioner Fellowship","award":["GNT1154828"],"award-info":[{"award-number":["GNT1154828"]}]},{"DOI":"10.13039\/501100000925","name":"NHMRC","doi-asserted-by":"publisher","award":["GNT1172873"],"award-info":[{"award-number":["GNT1172873"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"to E. P. F. C."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Rising 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We developed an integrated transmission-dynamic and health-economic model, calibrated with 2012\u20132022 Australian GBMSM data. Over a 10-year period (2025\u20132034), we compared the base case with two scenarios: recommending self-DARE to men with higher sexual activity (\u201conly high group\u201d) or to all individuals (\u201cboth groups\u201d). We assessed changes in incidence, incremental cost-effectiveness ratios (ICERs), and benefit-cost ratios.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The base case projected 110 501 new infections over 10 years. The \u201conly high group\u201d strategy averted 57 115 infections (51.7%) and was cost saving (negative ICER), with a benefit-cost ratio of 2.5. The \u201cboth groups\u201d 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Self-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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf310","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T13:01:56Z","timestamp":1752584516000},"page":"e393-e402","source":"Crossref","is-referenced-by-count":2,"title":["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"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0277-9364","authenticated-orcid":false,"given":"Hao","family":"Lai","sequence":"first","affiliation":[{"name":"Phase I Clinical Trial Research Ward, The Second Affiliated Hospital of Xi\u2019an Jiaotong University , Xi'an, China"},{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi\u2019an Jiaotong University Health Science Center ,","place":["China"]},{"name":"Melbourne Sexual Health Centre, Alfred Health ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Y","family":"Chen","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne ,","place":["Australia"]},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basil","family":"Donovan","sequence":"additional","affiliation":[{"name":"The Kirby Institute, University of New South Wales , Sydney ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denton","family":"Callander","sequence":"additional","affiliation":[{"name":"The Kirby Institute, University of New 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,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Science, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingwang","family":"Shen","sequence":"additional","affiliation":[{"name":"China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi\u2019an Jiaotong University Health Science Center ,","place":["China"]},{"name":"Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province , Xi\u2019an Jiaotong University, China"},{"name":"The Interdisciplinary Center for Mathematics and Life Sciences, School of Mathematics and Statistics, Xi\u2019an Jiaotong University , China"},{"name":"Key Laboratory of Environment and Genes Related to Diseases (Xi\u2019an Jiaotong University), Ministry of Education 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