We recommend MSM are screened for syphilis every three months. In the SEAS studies, we examined whether weekly anal self-examination might increase early detection of syphilis in men who practise receptive or versatile anal sex in addition to the 3-monthly screening.
SEAS series of studies examined:
- views and opinions of MSM on adopting anal self-examination as a regular practice
- acceptability and preferences of MSM on regular anal self-examination
- adherence to weekly anal self-examination schedule
The outcomes of each study are summarised below.
SEAS-Q
Alfred Hospital Ethics approval number 735-19
This qualitative study explored what MSM think of anal self-examination. We asked 20 participants for their views on adopting anal self-examination as a regular practice for syphilis detection in future.
The study participants found the idea of regular anal self-examination to be acceptable.
SEAS-S
Alfred Hospital Ethics approval number 366-20
This survey explored the attitudes and willingness of MSM to practise anal self-examination in future, if it was proven to be effective in detection of anal syphilis.
A total of 574 MSM answered a survey about anal self-examination.
The study participants found practising regular anal self-examination to be acceptable. About a third of the study participants were already practising anal self-examination.
SEAS-DCE study
Alfred Hospital Ethics approval number 366-20
This study was part of the survey study and examined the preferences and trade-offs in adopting anal self-examination as a regular practice using a discrete choice experiment (DCE).
The study participants from the SEAS-S (survey) study answered different scenarios about their preferred choices in practising anal self-examination. There were 574 men who answered the survey.
We found that the choices to practise anal self-examination were mostly influenced by:
- how often MSM should do the anal self-examination
- how effective the anal self-examination is to detect anal syphilis
SEAS-P
Alfred Hospital Ethics approval number 603-20
This pilot study examined if men could practise weekly anal self-examination regularly for anal syphilis detection.
We asked 30 MSM to practise weekly anal self-examination over a 12 week study period. The participants answered surveys and kept a logbook of their practice.
Most men (86%) practised anal self-examination at least once a week during the study period.
Researchers
Principal investigators
Associate investigators
Associate investigator
All research in Australia involving humans is reviewed by an independent group of people called a Human Research Ethics Committee (HREC). The ethical aspects of this research project have been approved by the Alfred Hospital HREC.
This project will be carried out according to the National Statement on Ethical Conduct in Human Research (2007). This statement has been developed to protect the interests of people who agree to participate in human research studies. Approval has been given by the Alfred Hospital HREC which reviews ethics applications for research carried out at the Melbourne Sexual Health Centre.
Publications
A cross-sectional survey on attitudes of men who have sex with men towards anal self-examination for detection of anal syphilis
Aung ET, Fairley CK, Ong JJ, Phillips TR, Chen MY, Tran J, Maddaford K, Rodriguez ER, Chow EPF
(2022), Scientific Reports,
A cross-sectional study of male and female kissing partners among men who have sex with men
Eric P. F. Chow, Tiffany R. Phillips, Julien Tran, Ei T. Aung, Kate Maddaford and Christopher K. Fairley
(2022), Sexual Health,
DOI: 10.1071/SH21184
Exploring the attitudes of men who have sex with men on anal self-examination for early detection of primary anorectal syphilis: a qualitative study
Aung ET, Fairley CK, Ong JJ
(2021), BMC Infectious Diseases,