Date of Conferral

9-18-2026

Date of Award

September 2026

Degree

Doctor of Public Health (DrPH)

School

Health Sciences

Advisor

Daniel Okenu

Abstract

Syphilis remains an ongoing public health concern among African American men. Elevated rates during the COVID-19 pandemic further underscored the need for focused attention on this population. The risk factors driving syphilis diagnosis among African American men during a pandemic like COVID-19 remain poorly understood. The purpose of this quantitative cross-sectional study was to examine the association between sexual orientation and syphilis diagnosis among African American men in Colorado. Social cognitive theory was applied to understand the interaction among sexual orientation, HIV status, age, and syphilis diagnosis. Sexual orientation categories include men who have sex with men (MSM), men who have sex with men and women (MSMW), men who have sex with women only (MSW), and men who have sex with unknown partners (MSU). Secondary data were drawn from the national Centers for Disease Control and Prevention (CDC) STI surveillance system (N = 237) and included African American men in Colorado. Logistic regression was used to assess these associations while controlling for age and HIV status. Compared with MSW, MSM showed greater odds of syphilis diagnosis (OR = 2.61, 95% CI [1.68, 4.07], p < .001), as did MSMW (OR = 1.87, 95% CI [1.21, 2.89], p < .01). HIV-positive status also predicted diagnosis (OR = 2.11, 95% CI [1.39, 3.20], p < .001). These results underscore the need for public health programs that support timely syphilis diagnosis among African American men, particularly MSM and MSMW, through low-cost mobile screening for high-risk men, telemedicine testing during public-health crises, and community-based campaigns that reduce STI stigma and screening disparities.

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