Grant: Travel Awards - Institute Community Support

Background: Syphilis is an emerging public health threat in Canada. In the Kingston, Frontenac and Lennox and Addington (KFL&A) region, 2022 infectious syphilis rates are almost twice as high as the provincial average. While syphilis has historically been associated with men who have sex with men (MSM), there has been an epidemiological shift towards heterosexual populations, including people who are un(der)housed and people who use drugs (PWUD). Equity-deserving communities face unique challenges-including competing priorities, stigma, and discrimination in health care-that can complicate syphilis testing access, preventing timely treatment and contributing to ongoing transmission. Methods: This study aims to identify barriers and facilitators to syphilis testing among people experiencing housing instability and PWUD in the KFL&A region. We will conduct one-hour, individual semi-structured interviews guided by the socioecological framework and a multidisciplinary team of public health nurses, social workers, and academic researchers. Participant recruitment will occur via KFL&A Public Health outreach events at community-based organizations, compensating participants with $30 gift cards. An interpretive description approach will be used to thematically analyze the data, allowing for in-depth inductive and deductive analyses of individual's experiences and broader social conditions that influence testing decisions. Conclusion: Findings will offer insights into how local health services can better support equity-deserving populations in accessing syphilis testing, particularly those facing intersecting challenges of housing insecurity and substance use. Ultimately, this research will guide the development of more tailored, community-focused strategies to improve syphilis detection and reduce the spread of infection in the KFL&A region.