A systematic approach for early identification of Syphilis Infection among Men having Sex with Men in Chennai City: - A Page Rank Based Approach

  • Kabilan Annadurai School of Public Health, SRM University
  • M Bagavandas School of Public Health, SRM University.



National surveillance conducted over 12 year period (2003 -2015) indicated that though the prevalence of HIV among Men having Sex with Men (MSM) has decreased in India, it is the second highest contributor in 2015. However, the prevalence of syphilis is an increase in the past 15 years. Under reach for screening; conscious hiding or withholding information due to stigma; limited resources and difficulty in screening vulnerable


The primary objective of the study is to explore the feasibility of using SNA for early identification of syphilis infection among MSM.


All MSM with newly identified syphilis infection in Chennai City during October and December 2015 were included in the study. A total of six samples were identified from the STI clinics lead by Government Hospitals in Chennai City, India and contact tracing at two levels (exponential snow-ball sampling method) were completed by the researcher. Unlike traditional screening program, the questionnaire used had indirect questions to avoid direct confrontation that helped to reach a total of 146 MSM during Jan to Oct 2016. Overall page ranking was completed for all MSM. All were followed up and encouraged to attend RTI/STI screening clinic through peers regularly.


24 MSMs attended syphilis RPR screening test during this 10 month study period. 12 of 13 MSM were found to be positive for syphilis had page rank value of greater than one and 1 MSM had less than one page rank value. In the case of identified negative, all (n=11) except one MSM had page rank value less than one. Statistically, correlation of page ranking with syphilis reactive value showed a strong linear positive relationship (r = 0.732) with highly significance (p-value 0.000).


This study proved that contact tracing and page ranking in SNA could be an effective measure to early identify syphilis infected MSM.With its high positivity rate (54.2%),


1. Baruah PK. Retrospectrive Study of Six District Level HIV / Aids Epidemiological Profiles of Assam. 2015;5(11):1729–43.
2. Satheesh BC, Thilak SA, Sarada AK, Madusoodanan K V, Venugopalan PP. A study on awareness of HIV among first year MBBS students in a private Medical College , Kerala , India. Int J Community Med Public Heal. 2016; 3(8):2305–8.
3. Basu I, Jana S, Rotheram-Borus MJ, Swendeman D, Lee S-J, Newman P, et al. HIV prevention among sex workers in India. J Acquir Immune Defic Syndr [Internet]. 2004;36(3):845–52.
4. National AIDS Control Organisation. HIV Sentinel Surveillance 2012-13: Technical Brief. 2014.
5. NACO. National Integrated Biological and Behavioural Surveillance (IBBS) 2014-15 High Risk Groups. 2015;5–308.
6. M. P, N. P, A. G, A. D. Syphilis screening for high-risk groups in a large-scale HIV prevention program in India: Uptake and trends. Sex Transm Infect. 2011;87:A343.
7. Sethi S, Mewara A, Hallur V, Prasad A, Sharma K, Raj A. Rising trends of syphilis in a tertiary care center in North India. Indian J Sex Transm Dis. 2015;36(2):140-143.
8. Kumarasamy N, Balakrishnan P, Venkatesh KK, et al. Prevalence and incidence of sexually transmitted infections among South Indians at increased risk of HIV infection. AIDS Patient Care STDS. 2008;22(8):677-682.
9. Thappa DM, Kaimal S. Sexually transmitted infections in India: Current status (except human immunodeficiency virus/acquired immunodeficiency syndrome). Indian J Dermatol. 2007;52:78-82.
10. Higa DH, Crepaz N, Marshall KJ, et al. A systematic review to identify challenges of demonstrating efficacy of HIV behavioral interventions for gay, bisexual, and other men who have sex with men (MSM). AIDS Behav. 2013;17(4):1231-1244.
11. Solomon, S. S., Srikrishnan, A. K., Sifakis, F., Mehta, S. H., Vasudevan, C. K., Balakrishnan, P., … Celentano, D. D. The emerging HIV epidemic among men who have sex with men in tamil nadu, india: Geographic diffusion and bisexual concurrency. AIDS and Behavior, 2010;14(5), 1001–10.
12. Thomas, B., Mimiaga, M. J., Mayer, K. H., Perry, N. S., Swaminathan, S., & Safren, S. a. The influence of stigma on HIV risk behavior among men who have sex with men in Chennai, India. AIDS Care, 2012;24(11), 1401–6.
13. Zelaya, C. E., Sivaram, S., Johnson, S. C., Srikrishnan, a. K., Suniti, S., & Celentano, D. D. Measurement of self, experienced, and perceived HIV/AIDS stigma using parallel scales in Chennai, India. AIDS Care, 2012;24(7), 846–855.
14. Kodavalla V, Rachakulla HK, Rajkumar H. Impact of Intervention Program on Sexual Behavior , HIV and Sexually Transmitted Infections among Self-Identified Men Who Have Sex with Men in Select Districts of Andhra Pradesh , India. 2014;(December):458–69.
15. Luo Y, Zhu C, Chen S, et al. Risk factors for HIV and syphilis infection among male sex workers who have sex with men: a cross-sectional study in Hangzhou, China, 2011. BMJ Open. 2015;5(4):e006791.
16. Godbole, S., Sane, S., Kamble, P., Raj, Y., Dulhani, N., Venkatesh, S., … Risbud, A. Predictors of bisexual behaviour among MSM attending intervention sites may help in prevention interventions for this bridge to the heterosexual epidemic in India: Data from HIV sentinel surveillance. PLoS ONE, 2014;9(9).
17. Latkin, C., Yang, C., Tobin, K., Roebuck, G., Spikes, P., & Patterson, J. Social network predictors of disclosure of MSM behavior and HIV-positive serostatus among African American MSM in Baltimore, Maryland. AIDS and Behavior,2012; 16(3), 535–542.
18. Périssé, A. R. S., & Nery, J. A. da C. The relevance of social network analysis on the epidemiology and prevention of sexually transmitted diseases. Cadernos de Saúde Pública, 2007;23(3), S361–S369.
19. Wasserman, S., & Faust, K. (1995). Cohesive Subgroups. In Social Network Analysis: Methods and Applications (pp. 249–290).
20. Danon, L., House, T. a, Read, J. M., & Keeling, M. J. Social encounter networks: collective properties and disease transmission. Journal of the Royal Society, Interface / the Royal Society, 2012;9(76), 2826–33.
21. Keeling, M. J., House, T., Cooper, A. J., & Pellis, L. Systematic Approximations to Susceptible-Infectious-Susceptible Dynamics on Networks. PLoS Computational Biology,2016; 12(12), 1–18.
22. D. D. Heckathorn, “Respondent-driven sampling: a new approach to the study of hidden populations,” Social Problems, vol. 44, no. 2, pp. 174–199, 1997
23. Wang R., Zhang W., Deng H., Wang N., Miao Q., Zhao X. (2013) Discover Community Leader in Social Network with PageRank. In: Tan Y., Shi Y., Mo H. (eds) Advances in Swarm Intelligence. ICSI 2013. Lecture Notes in Computer Science, vol 7929. Springer, Berlin, Heidelberg
24. Gupte S, Daly C, Agarwal V, Gaikwad SB, George B. Introduction of rapid tests for large-scale syphilis screening among female, male, and transgender sex workers in mumbai, India. Sex Transm Dis. 2011;38(6):499-502.
25. McInnes D, Bradley J, Prestage G. The discourse of gay men’s group sex: The importance of masculinity. Cult Health Sex [Internet]. 2009;11(6):641–54.
26. Karp G, Schlaeffer F, Jotkowitz A, Riesenberg K. Syphilis and HIV co-infection. Vol. 20, European Journal of Internal Medicine. 2009. p. 9–13.
27. Aggarwal P, Bhattar S, Sahani SK, Bhalla P, Garg VK. Sexually transmitted infections and HIV in self reporting men who have sex with men: A two-year study from India. J Infect Public Health [Internet]. 2016;9(5):564–70.
28. Parthasarathy M, Potty N, Gurung A, et al P5-S7.03 Syphilis screening for high-risk groups in a large-scale HIV prevention program in India: uptake and trends Sex Transm Infect 2011;87:A343.
29. Amirkhanian YA, Kelly JA, Takacs J, Mcauliffe TL, Kuznetsova A V, Toth TP, et al. Effects of a Social Network HIV/STD Prevention Intervention for Men Who Have Sex with Men in Russia and Hungary: A Randomized Controlled Trial HHS Public Access. AIDS March. 2015;13(295):583–93.
30. Amirkhanian YA. Social networks, sexual networks and HIV risk in men who have sex with men. Curr HIV/AIDS Rep. 2014;11(1):81-92.
How to Cite
ANNADURAI, Kabilan; BAGAVANDAS, M. A systematic approach for early identification of Syphilis Infection among Men having Sex with Men in Chennai City: - A Page Rank Based Approach. Indian Journal of Community Health, [S.l.], v. 29, n. 4, dec. 2017. ISSN 2248-9509. Available at: <http://www.iapsmupuk.org/journal/index.php/IJCH/article/view/1959>. Date accessed: 23 mar. 2018.
Original Article