Kufa, TendesayiTobaiwa, OceanCutler, EwaldeSingh, BeverleyBrukwe, ZinhleMaseko, VenessaPillay, ErushkaMoyo, KhumbulaniZondi, LindokuhlePillay, YoganPatrick, Sean MarkPuren, Adrian2024-11-212024-11-212024-08-30Kufa, T., Tobaiwa, O., Cutler, E., et al. Acceptability and performance of dual HIV/syphilis testing in male circumcision clients, 2021. Southern African Journal of HIV Medicine 2024;25(1), a1571. https://DOI.org/10.4102/sajhivmed.v25i1.1571.1608-9693 (print)2078-6751 (online)10.4102/sajhivmed.v25i1.1571http://hdl.handle.net/2263/99225DATA AVAILABILITY : The data used to determine all outcomes included in this study are available on request from the NICD, subject to submission of a data request and signing of a data sharing agreement. Please contact the corresponding author, T.K., for data requests.BACKGROUND : Dual HIV/syphilis testing may be an acceptable intervention to identify men with sexually transmitted infections (STIs) and at risk of HIV acquisition. OBJECTIVES : We sought to determine the acceptability, and performance of dual HIV/syphilis testing among men attending voluntary medical male circumcision (VMMC) services at six public sector facilities in Gauteng. METHOD : This was a cross-sectional study at VMMC facilities. Men ≥ 18 years were enrolled. The men had (1) a questionnaire administered, (2) on-site dual HIV/syphilis testing with First Response HIV1+2/Syphilis Combo Card Test by routine lay counsellors, and (3) a blood specimen collected for centralised laboratory testing for HIV and syphilis serology. We evaluated pre-test and post-test acceptability and performance compared to serological testing. RESULTS : Of the 679 men analysed (median age 32.1 years), 96.7% of HIV-negative men preferred testing for HIV and syphilis simultaneously. Of the 675 men tested for syphilis, 28 (4.7%) tested positive (past or recent). In the laboratory, 43/609 (7.1%) had syphilis infection detected, with 9/609 (1.5%) having recent syphilis. There was sub-optimal sensitivity for HIV detection (90.9%; 95% confidence interval [CI]: 88.5% – 93.3%), and for past/recent syphilis (55.8%; 95% CI: 51.9% – 59.8%), improving to 88.9% (95% CI: 86.4% – 91.4%) for recent syphilis. Specificities were > 99% for HIV and syphilis (past or recent). Post-test acceptability was 96.6% and willingness to pay for future testing was 86.1%. CONCLUSION : Dual HIV/syphilis testing was acceptable but had sub-optimal sensitivity for HIV and syphilis. Syphilis detection was adequate for recent infection.en© 2024. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.Male circumcisionSyphilisDual testingAcceptabilityPerformanceHuman immunodeficiency virus (HIV)Sexually transmitted infection (STI)HIV/syphilis testingVoluntary medical male circumcision (VMMC)SyphilisSDG-03: Good health and well-beingArticle