(P135) COMMUNITY-ENGAGEMENT TO REDUCE SYPHILIS MORBIDITY AMONG BLACK MEN WHO HAVE SEX WITH MEN (MSM) IN MARION COUNTY: EXAMINING THE ROLE OF SOCIAL DETERMINANTS OF HEALTH IN SYPHILIS ACQUISITION

Background:
Despite only representing 29.6% of the total population in Marion County, the Black non-Hispanic (NH) population represented 51% of all early syphilis cases, with MSM accounting for 54% of all early cases in 2021. Data from 2022 and 2023 suggest a downward trend in syphilis morbidity among MSM, from 54% to 34.3%, yet MSM and the Black NH populations still account for a large proportion of syphilis cases in Marion County. Research suggests Black MSM do not engage in riskier individual and interpersonal-level behaviors when compared to their White counterparts. These findings indicate higher level disparities operating at the community, societal, and structural levels; therefore, we conducted a literature review to examine social determinants of health to initiate discussion among a community advisory board (CAB) of Black MSM.

Methods:
A narrative literature review was conducted through Google Scholar and APA PsycArticles between January – February 2024. The search aimed to include racial, gender, and sexual minorities with a focus on urban geographic locales with high syphilis and sexually transmitted infection morbidity.

Results:
A total of 28 peer-reviewed articles were included in the narrative literature review exploring barriers to engaging in syphilis care and the historical context of structural bias, social inequities, and racism. The most frequently cited barriers to engaging in syphilis screening and treatment included the implications of low socioeconomic status (n=6), availability of resources (n=5), geographic location (n=2), anticipated stigma (n=6), enacted stigma (n=4), internalized stigma (n=1), and social support (n=4).

Conclusion:
Understanding what barriers exist across the literature provides insight into future intervention strategies in reducing syphilis among Black MSM. The barriers identified in this review are not exhaustive and may differ across communities. Therefore, results will be used to initiate discussion among CAB members to determine salient barriers to engaging in syphilis care in Marion County.