{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:02:36Z","timestamp":1785546156675,"version":"3.56.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1172873"],"award-info":[{"award-number":["GNT1172873"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NHMRC Emerging Leadership Investigator","award":["GNT1193955"],"award-info":[{"award-number":["GNT1193955"]}]},{"name":"NHMRC Emerging Leadership Investigator","award":["GNT2033299"],"award-info":[{"award-number":["GNT2033299"]}]},{"name":"NHMRC Emerging Leadership Investigator","award":["GNT1172900"],"award-info":[{"award-number":["GNT1172900"]}]},{"name":"Australian Government Research Training Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary anorectal syphilis may go unnoticed in men who have sex with men (MSM) engaging in receptive anal sex. This study examined whether weekly digital anorectal examination (DARE) could help men self-detect abnormalities indicative of primary anorectal syphilis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort study of MSM aged \u226518 years who engage in receptive anal sex was conducted at the Melbourne Sexual Health Centre from 9 March 2022 to 4 August 2023. Participants received instructions on how to perform DARE, along with weekly text reminders for 48 weeks. Those who self-detected abnormalities were advised to seek clinical consultation. The primary outcome was the proportion of syphilis cases detected via DARE. Secondary outcomes included reports of DARE-related abnormalities, adherence, and experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 222 men recruited, six men (2.7%; 95% CI: 1.0\u20135.8) were diagnosed with syphilis\u20141 primary anorectal infection detected by DARE, 2 secondary infections, and 3 early latent syphilis infections. There were 32 clinical consultations prompted by DARE. On average, men performed 78.2% (95% CI: 77.3\u201379.0) of their weekly DARE which showed no significant variation over time (Ptrend = 0.26). Most found DARE easy to perform (&amp;gt;95.0%) and would continue performing it if recommended for early syphilis detection (77.6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Men's high adherence to performing we DARE suggests that it may complement routine screening for primary anorectal syphilis. However, its sensitivity may be limited, as 5 of 6 early syphilis cases did not have primary lesions that were self-detected by the 5 men.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf628","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:17:44Z","timestamp":1765372664000},"page":"e696-e705","source":"Crossref","is-referenced-by-count":1,"title":["Digital Anorectal Examination to Self-detect Primary Syphilis: A Prospective Cohort Study"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3139-7090","authenticated-orcid":false,"given":"Julien","family":"Tran","sequence":"first","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5213-1289","authenticated-orcid":false,"given":"Kate","family":"Maddaford","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5784-7403","authenticated-orcid":false,"given":"Jason J","family":"Ong","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2560-3233","authenticated-orcid":false,"given":"Ei T","family":"Aung","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9081-1664","authenticated-orcid":false,"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":false,"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria ,","place":["Australia"]},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"2026031710050534600_jiaf628-B1","doi-asserted-by":"crossref","first-page":"e0143304","DOI":"10.1371\/journal.pone.0143304","article-title":"Global estimates of the prevalence and incidence 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