Syphilis Education & Elimination in the US (SEE-US): A citizen science approach to reducing syphilis and HIV/STIs among reproductive-aged women in the US

About This Grant

PROJECT SUMMARY/ABSTRACT This project will assess whether digital crowdsourced messaging can increase syphilis/HIV/STI testing among women in two sites in the US (urban New York City and rural Alabama, including among Native American women). Syphilis rates in the US are the highest in 40 years, and rates are increasing more rapidly among women than men. Syphilis rates are up to ten times higher among women of color than among non-Hispanic White women. Women of color underutilize testing services, and stigma and medical mistrust remain significant barriers to syphilis/HIV/STI testing uptake. Different cultures require tailored dissemination messaging that speaks to and is relevant for their local context. Citizen science approaches, such as crowdsourcing (i.e., engaging groups of individuals online to address public health challenges and share solutions), are scalable, cost-effective implementation strategies that can increase syphilis/HIV/STI testing services and reduce stigma in resource-constrained settings. Crowdsourcing can be used to engage communities in developing culturally-relevant, locally-tailored messaging to promote syphilis/HIV/STI testing. Complementing crowdsourcing, specimen self-collection with remote syphilis/HIV/STI testing is another strategy that may also reduce stigma and increase access to testing, especially for women in rural or other resource-constrained areas. Study aims are: 1) to develop crowdsourced digital messages to promote syphilis/HIV/STI testing among women ages 18-45 in the United States and compare community preferences for digital content; 2) in a parallel, Hybrid Type 3 randomized controlled trial, to compare the crowdsourced dissemination messaging to existing public health messaging in increasing syphilis/HIV/STI testing among women (n=1,176) in rural AL and urban NYC, including among Native American women; and 3) using an integrated implementation science framework and a mixed methods approach, we will examine the contribution of multi-level factors on implementation outcomes, particularly effectiveness and broader community reach. This work will result in digital crowdsourced messaging to increase syphilis/HIV/STI testing uptake among demographically and geographically disparate women in the US. This project will also result in a crowdsourcing and messaging toolkit that can be broadly distributed to public health agencies across the country for their use in leveraging community voices to design culturally appropriate and relevant messaging campaigns to address the syphilis/HIV/STI epidemics and other public health issues in their communities. Findings from this project will lay the groundwork for community-developed dissemination messaging for women across the US to reduce syphilis rates among women and newborns nationally.