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Table 6 Example quotes around the acceptability of anal self-examination for syphilis detection (Theme 4)

From: Exploring the attitudes of men who have sex with men on anal self-examination for early detection of primary anorectal syphilis: a qualitative study

Acceptability of anal self-examination for detection of syphilis

Quote

Open to perform anal self-examination when proven effective

“If it becomes part of some evidence-based treatment guideline or prevention guideline, sure.”

—Participant 9, not living with HIV and taking PrEP

Acceptable to perform anal self-examination if recommended by a health professional

“It's something I would be prepared to do if it was recommended by a GP or a doctor, yes”

—Participant 13, not living with HIV and not taking PrEP

Preference for a health professional performing anal examination rather than self-examination

“I think for me, personally, it would be the fact that I wouldn’t be confident in knowing what I was looking for if I was to do it myself, and that probably would put me off doing it myself. I’d prefer someone—well, I wouldn’t really want someone else to check, like a doctor or something, but if I had to, I would, if that makes sense, because I know they know what they’re looking for.”

—Participant 5, not living with HIV and not taking PrEP

Already performing regular anal self-examination for health reasons

“I think so [it would be acceptable], because anything that is going to help to screen for any sort of STI more quickly is gonna benefit gay community, I think. Any research to slow down syphilis I think any gay man will be happy to do whatever it takes. That’s my opinion.”

—Participant 1, living with HIV

Challenges of anal self-examination as a means for syphilis detection

“So, I think if you could learn to do it yourself and check I think that would take a lot of worry out of having to think I have to go to the doctor to get that checked… but you also don’t want to go the other way where then people go I don’t need to go see a doctor for a screen because I’m doing it myself. So, it’s sort of a double edge sword in a way.”

—Participant 11, living with HIV

Challenges of anal self-examination as a means for syphilis detection

“..I kind of think the gay community would totally be up for self-inspecting, but I don’t think the risk of STD contraction would go down, because the general … I think the general consensus is so many people are just having unprotected sex now, because of PrEP. So yes, I think … a lot of the gay community would feel comfortable doing it, but I don’t think it would stop or limit (STI risk) …”

—Participant 4, not living with HIV and taking PrEP