P5-S4.05 The use of financial compensation as an incentive for infectious syphilis case finding among vulnerable populations in Edmonton, Canada
Bibliographic record
Abstract
Background Edmonton, Canada has been experiencing a rise in infectious syphilis cases since 2003, attributed to individuals engaging in transactional sex and substance use. As well, Aboriginal people had disproportionately higher rates of the infection. The results of a case study of primary syphilis cases were shared with community organisations serving vulnerable populations to ascertain their suggestions on strategies to increase testing for syphilis among this population. Agencies suggested that compensating clients for syphilis screening at a community organisation would increase testing rates. We sought to determine if more cases among the target population were diagnosed through outreach testing that provided financial compensation than by routine screening methods by other healthcare professionals. Methods A data extract containing demographics, ethnicity, and risk behaviours for infectious syphilis cases in Edmonton between April 2007 and November 2008 was obtained from the provincial STI database. An additional database, which held demographic and risk group information on participants in the project, was also analysed. Client demographics and risk behaviours were compared using χ 2 or Fisher's exact test for categorical variables and Mann–Whitney for continuous variables. Results A total of 931 testing visits were completed with 877 individuals. Three-quarters of individuals reported a history of substance use (77.1%; n=676) with more than one-quarter of individuals involved in transactional sex, either as a sex worker (n=204) or contact with a sex worker (n=110). Over half of the individuals (51.3%; n=450) were Aboriginal. Ten newly diagnosed infectious syphilis cases were found. The proportion of cases detected among female sex workers was 2.9% (6 cases out of 209 testing visits) and was 2.0% (2 cases out of 98 testing visits) among male sexual contacts of sex workers. Female cases were more likely to be a sex worker when tested through outreach (75%) than by routine testing sites (23.5%, p=0.006) see Abstract P5-S4.05 table 1. Abstract P5-S4.05 Table 1 Comparison of characteristics of infectious syphilis cases (N=155) Factor Number of cases Outreach cases, n=10 (%) Routine testing cases n= 145 (%) Total, N= 155 (%) p Value Gender Female 8 (80.0) 68 (46.9) 76 (49.0 0.05 Male 2 (20.0) 77 (53.1) 79 (51.0) Ethnicity Aboriginal 7 (70.0) 58 (40.0) 65 (41.9) 0.10 Non-aboriginal 3 (30.0) 87 (60.0) 90 (58.1) Median age (IQR) 32.5 (21.25–37.5) 32 (24–43) 32 (24–42) 0.71 Risk behaviour Heterosexual 10 (100.0) 107 (83.6) 117 (84.8) 0.16 Injection drug use 2 (20.0) 11 (7.6) 13 (8.4) 0.20 Sex with an IDU 0 8 (5.5) 8 (5.2) 1.00 Sex worker Female 6 (75.0) 16 (23.5) 22 (28.9) 0.006 Male 0 1 (1.3) 1 (1.3) 1.00 Sex with a sex worker (males only) 2 (100.0) 22 (28.6) 24 (30.4) 0.09 Conclusions By offering testing at community agencies with financial compensation to individuals, a higher rate of cases were found among sex workers than through routine testing methods. By treating cases among individuals linked to high transmission activity, we aim to reduce the transmission of infectious syphilis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".