Innovations and Challenges in Syphilis Screening and Prevention Among Men Who Have Sex With Men: A Scoping Review

Syphilis rates among men who have sex with men have risen sharply worldwide, reflecting evolving sexual networks, persistent gaps in screening and care, and behavioral changes that have accompanied the broader uptake of HIV preexposure prophylaxis. At the same time, a new generation of biomedical tools, such as doxycycline postexposure prophylaxis and rapid point-of-care diagnostics, are reshaping prevention. However, implementation has been inconsistent across programs and jurisdictions, and important challenges remain in access, effectiveness, and sustainability. This narrative review synthesizes current evidence on innovative syphilis screening and prevention strategies among men who have sex with men, highlighting both promising interventions and critical limitations. We emphasize doxycycline postexposure prophylaxis, point-of-care testing, self-testing, and digital health innovations for their potential to extend reach to underserved populations and address structural barriers to care and argue that durable control of the epidemic will require equity-focused, multidisciplinary strategies integrating clinical, public health, and community-based efforts.