Grant: Op. Gr.:Addressing Infectious/Congenital Syphilis-Syphilis Impl. Science-General

Urgent, tailored, and equitable action is needed to address the alarming rise in syphilis rates in Canada. Syphilis is a curable infection, yet systemic barriers obstruct access to effective interventions. Given the shift in epidemiology and the stark geographic disparities in resources, there is no one-size-fits-all solution to this complex issue. Underserved communities-people who use drugs (PWUD), sex workers, and people un(der)housed- face unique social and healthcare challenges that increase their vulnerability to syphilis infections and hinder their access to timely diagnosis and treatment. Low-barrier interventions such as the use of point-of-care tests (POCT) outside traditional healthcare settings have been shown to be an effective strategy for reaching underserved people living with hepatitis C and HIV. However, implementation and effectiveness studies for similar interventions for other sexually transmitted and blood-borne infections (STBBIs), particularly in non-urban, rural and remote settings, is still needed. Our proposal's overarching goal is to improve access and reach to syphilis testing and immediate treatment for underserved populations living in non-urban and rural settings. We will expand and evaluate our pilot project, which links "rapid POCT and immediate treatment" with existing outreach services offered by the public health units (PHUs) through community-based organizations throughout Ontario. Concurrently, we will determine the preferences for syphilis testing and treatment among underserved populations. This proposal enables innovative, community-centred research that incorporates community preferences, ensuring that research outcomes are aligned with the needs of these populations. Moreover, we intend to continue leveraging our partnerships to achieve our research objectives and solidify infrastructure support for long-term cross-disciplinary collaborations between public health units and other experts in relevant fields.