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Monitoring and Evaluation Proposal

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Monitoring and evaluation proposal for National Gay Men’s Syphilis Action Plan. Presentation given by Rebecca Guy and Michelle McPherson at the AFAO National Syphilis Forum, 23 October 2009.

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Monitoring and Evaluation Proposal

  1. 1. Monitoring and Evaluation Proposal National Gay Men’s Syphilis Action Plan 23th October 2009 Rebecca Guy and Michelle McPherson
  2. 2. Evaluation approach <ul><ul><li>Before and after evaluation </li></ul></ul>Inputs/processes Outputs Outcomes (short-term) Impact (long-term)
  3. 3. Objectives <ul><li>Objectives </li></ul><ul><li>To evaluate the impact of the ‘activities’ on syphilis infection in gay men </li></ul><ul><li>To quantify increased syphilis testing among gay men </li></ul><ul><li>To quantify increased partner notification among gay men diagnosed with infectious syphilis </li></ul><ul><li>To assess the coverage, progress and impact of local activities undertaken in the NGMSAP </li></ul><ul><li>To obtain endorsement of the Plan at a national and jurisdictional level </li></ul><ul><li>To assess change in syphilis knowledge and sexual behaviour in gay men </li></ul><ul><li>To evaluate the acceptability of the NGMSAP activities on gay men and stakeholders </li></ul>
  4. 4. 1. To evaluate the impact of the ‘activities’ on syphilis infection in gay men <ul><li>Number of notifications of infectious syphilis </li></ul><ul><li>Syphilis prevalence </li></ul><ul><li>Modelled syphilis epidemic trends </li></ul>
  5. 5. 2. To quantify increased syphilis testing among gay men <ul><li>Annually, percentages of </li></ul><ul><li>HIV + men having 3+ tests </li></ul><ul><li>HIV- men having 2+ tests </li></ul><ul><li>men tested for HIV also tested for syphilis </li></ul><ul><li>men with 20+ partners per 6 months tested 2+ times </li></ul><ul><li>men never tested </li></ul><ul><li>Plus </li></ul><ul><li>Total number of tests outside clinical settings </li></ul>
  6. 6. 3. To quantify increased partner notification among gay men diagnosed with infectious syphilis <ul><li>% Notifications where contact tracing done </li></ul><ul><li>Websites - number of hits/messages </li></ul><ul><li>The number of ‘contacts’ presenting for testing </li></ul>
  7. 7. 4. To assess the coverage, progress and impact of local activities undertaken in the NGMSAP <ul><li>Participants enrolled in syphilaxis trial by July 2010 </li></ul><ul><li>Awareness of campaign material </li></ul><ul><li>Description of activities and program evaluations </li></ul>
  8. 8. 5. To obtain endorsement of the Plan at a national and jurisdictional level <ul><li>NGMSAP recommendations in guidelines </li></ul><ul><li>Activities undertaken in response to Action Plan </li></ul>
  9. 9. 6. To assess changes in syphilis knowledge and sexual behaviour in gay men <ul><li>The % of men reporting </li></ul><ul><li>High levels of syphilis knowledge </li></ul><ul><li>Condom use with casual partners and other behaviour </li></ul>
  10. 10. 7. To evaluate the acceptability of the ‘activities’ on gay men <ul><li>Program acceptability among gay men and stakeholders </li></ul>
  11. 11. Data sources <ul><li>Notification data </li></ul><ul><li>GP testing data </li></ul><ul><li>Sexual health service data </li></ul><ul><li>Periodic Surveys </li></ul><ul><li>Jurisdictional questionnaire – program data </li></ul><ul><li>In-depth interviews with gay men/stakeholders </li></ul>
  12. 12. Data sources <ul><li>Notification data </li></ul><ul><li>GP testing data </li></ul><ul><li>Sexual health service data </li></ul><ul><li>Periodic Surveys </li></ul><ul><li>Jurisdictional questionnaire – program data </li></ul><ul><li>In-depth interviews with gay men/stakeholders </li></ul>
  13. 13. Sexual health service data
  14. 14. Sexual health service network <ul><ul><li>24 sexual health services participating </li></ul></ul><ul><li>Monitor chlamydia testing and diagnoses </li></ul><ul><li>Established in 2008 </li></ul><ul><li>Retrospective data from 2004 onwards </li></ul><ul><li>Funded by DoHA </li></ul><ul><li>Collaborators </li></ul><ul><ul><li>Sexual health services </li></ul></ul><ul><ul><li>National Centre in HIV Epidemiology & Clinical Research </li></ul></ul><ul><ul><li>Burnet Institute Centre for Population Health </li></ul></ul><ul><ul><li>National Serology Reference Laboratory </li></ul></ul><ul><ul><li>National Perinatal Statistics Unit </li></ul></ul>
  15. 15. Sites
  16. 16. Chlamydia annual testing rates and positivity in MSM, 19 sexual health services 2006 2007 2008 New patients 3509 3645 3800 Testing rate 77.7 80.1 81.6 Positivity rate (%) 7.2 6.5 7.3
  17. 17. Sexual health service network - Enhancements required <ul><li>Collation of new variables </li></ul><ul><li>Syphilis and HIV testing and results </li></ul><ul><li>HIV status </li></ul><ul><li>Number of sexual partners </li></ul><ul><li>Symptoms </li></ul><ul><li>Reason for test i.e contact of a case </li></ul>
  18. 18. Gay Community Periodic Surveys
  19. 19. Recent changes <ul><li>Previously </li></ul><ul><ul><li>‘ Other blood tests’ (proxy for syphilis) </li></ul></ul><ul><li>2009 additional question in Syd, QLD surveys </li></ul><ul><ul><li>‘ Syphilis test’ </li></ul></ul>
  20. 20. Syphilis testing frequency in MSM, Sydney Periodic Survey, 2009
  21. 21. Syphilis testing frequency in MSM reporting 11+ partners, Sydney Periodic Survey, 2009
  22. 22. Periodic Surveys – Possible Enhancements <ul><li>Number of sexual partners categories </li></ul><ul><ul><li>0, 1, 2-5, 6-10, 11-20, 21-60 , >60 </li></ul></ul><ul><li>Syphilis testing ever, in addition to last 12m </li></ul><ul><li>‘ Syphilis test’ rather than ‘other blood test’ – all jurisdictions </li></ul><ul><li>Knowledge questions? </li></ul>
  23. 23. Summary <ul><li>Notification data – collate data nationally </li></ul><ul><li>GP sentinel testing data – more states? </li></ul><ul><li>Sexual health service data – add variables </li></ul><ul><li>Periodic Survey – add questions </li></ul><ul><li>Process data –collate nationally from programs </li></ul><ul><li>In-depth interviews? </li></ul>
  24. 24. Acknowledgements <ul><li>Jurisdictions – Sue Botham (SES), Patrick Maywood (CS), Nasra Higgins (VIC), Craig Davis and Diane Rouwling (QLD), Carolien Giele (WA), Tess Davey (SA), Jiunn-Yih Su (NT), David Coleman (TAS) and Sue Reid (ACT) </li></ul><ul><li>Sexual health service network </li></ul><ul><li>NCHECR - Neil Franklin, Iryna Zablostka , Melanie Middleton , John Kaldor </li></ul><ul><li>Victorian Primary Care Network - Jane Goller (Burnet Institute) </li></ul>
  25. 25. ACT NT 1. Canberra Sexual Health Centre 16. Alice Springs Clinic 34 NSW 17. Darwin Clinic 34 2. Coffs Harbour SHS QLD 3. Greater Southern Area Health Service 18. Dolls House Sexual Health Clinic 4. Holden St Clinic Gosford 19. Gold Coast Sexual Health 5. Hunter New England Sexual Health Service 20. Princess Alexandra Sexual Health 6. Lismore / Tweed Heads Sexual Health Service 21. Townsville Sexual Health Service 7. Northern Sydney Sexual Health Service Tas 8. Sydney West Area Health Service – Eastern Division 22. Hobart Sexual Health Service (Laun, Devon, Hobart) 9. Sydney West Area Health Service – Western Division Vic 10. Orange Sexual Health Clinic 23. Melbourne Sexual Health Centre 11. Royal Prince Alfred Hospital WA 12. South East Sydney and Illawarra Health Service Fremantle Hospital SHS 13. Sydney Sexual Health Centre 14. St George Short St Clinic 15. Kirketon Road Centre
  26. 26. Chlamydia testing frequency in MSM, 19 sexual health services
  27. 27. MSM patients by jurisdiction, 19 sexual health services, 2006-2008 PASH not included here

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