Opportunities to Enhance Provider and Clinic-Based Interventions to Increase Syphilis Screening Among MSM Through the Application of Behavioral Theory: A Scoping Review of Reviews and Synthesis

The U.S. Preventive Services Task Force’s guidelines for syphilis screening in non-pregnant adults and adolescents recommends increased screening intervals for populations known to be at elevated risk, such as sexually active men who have sex with men (MSM) and persons living with HIV. Few investigations have examined compliance to these guidelines in clinical practice, and none have examined the role that social and cognitive factors at the provider level play in adhering to these practice guidelines. To this end, a systematic review of reviews of both the syphilis screening literature and the literature documenting the application of behavioral theory to assess healthcare professionals’ clinical behavior was used to identify opportunities for synthesis between these two research areas. Several databases were searched for review articles compiling original studies of both provider interventions to increase syphilis screening, and studies that apply behavioral theory to healthcare provider behavior and behavioral intentions. Reviews were included if published in English and included detailed description of the original articles. Five review articles met the inclusion criteria: Three focused on application of behavioral theory to clinician behavior and two focused on syphilis screening. From these reviews, 82 original articles were extracted: 70 from the theory literature and 12 from the syphilis screening literature. Reviewing both the theory literature and the syphilis screening literature provides insight into how these two areas of research may be synthesized, in the interest of enhancing provider-level interventions that result in increased adherence to screening guidelines.