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P4.98 Spiro, a patient-managed mobile application to improve syphilis treatment follow-up among men who have sex with men
  1. Sebastiaan Hulstein1,
  2. Menne Bartelsman1,
  3. Freke Zuure1,
  4. Udi Davidovich1,
  5. Amy Matser1,
  6. Arjan Hogewoning1,
  7. Henry DE Vries2
  1. 1Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands
  2. 2Academic Medical Centre, Department of Dermatology, Amsterdam, The Netherlands


Introduction Syphilis incidence is rising in developed countries worldwide, and men who have sex with men (MSM) are disproportionally affected. Follow-up after treatment of syphilis is important as late complications (e.g. neurosyphilis), therapy failure and re-infections can occur, especially in HIV co-infected patients. Failure to complete follow-up occurs frequently. Moreover, medical history at follow-up is often incomplete, as follow-up occurs often at various health care providers. Self-management of the relevant medical data might improve patient engagement, and ensure the availability of medical data required during follow-up visits.

Methods We developed a patient-managed mobile phone application – Spiro – that can be used by patients treated for syphilis, to record relevant data for follow-up like medical history, physical findings, treponomal (e.g. TTPA) and non-treponomal (e.g. VDRL) serum antibody results, conclusions and treatment. Spiro automatically summarises the data relevant for syphilis follow-up including a graphical depiction of the non-treponomal serum antibody titer over time. Follow-up data are stored locally on the mobile device. Optionally, encrypted online storage is available. Lay information on risk factors for, and symptoms, diagnosis and treatment of syphilis infections is available via the app.

Results After launching Spiro on World AIDS day 2016, we intend to measure its acceptability and usability among patients who use the app and their care providers. In addition, we plan to evaluate retention to follow-up, the availability of required data for syphilis treatment follow-up, health-literacy and self-reported level of disease control among MSM newly diagnosed with syphilis in a multi-centre RCT, comparing standard care plus the use of Spiro by patients to standard care alone.

Conclusion If feasible and effective, Spiro, a newly developed medical mobile phone application, can improve the engagement in, and retention to syphilis treatment follow-up among MSM.

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