Acceptability and preferred frequency of syphilis-focused SMS reminders for syphilis testing among men who have sex with men in Melbourne, Australia

Background Regular screening is important for syphilis control. We assessed acceptance of syphilis-focused SMS reminders for syphilis testing and preferred reminder frequency among men who have sex with men (MSM) attending a sexual health clinic in Australia. Methods We conducted a cross-sectional study of MSM attending the Melbourne Sexual Health Centre, Australia, between April 2024 and August 2025. Clients were presented with a proposed message describing syphilis epidemic among MSM, modes of transmission and asymptomatic infection, and then asked whether they would accept an SMS reminder for syphilis testing and their preferred reminder frequency (3-, 6-, or 12-monthly). Logistic and multinomial logistic regression analyses were used to identify factors associated with reminder acceptance and preferred reminder frequency. Results Among 6752 MSM, 56.4% (n = 3805) accepted SMS reminders. Overseas-born (adjusted odds ratio [aOR] 2.07, 95% CI: 1.81–2.36) and Aboriginal and Torres Strait Islander MSM (aOR 1.88, 95% CI: 1.10–3.22) were more likely to accept reminders, whereas PrEP users were less likely (aOR 0.74, 95% CI: 0.63–0.86). Among those who accepted reminders, 81.9% preferred reminders every 3 months, 16.1% every 6 months and 1.5% every 12 months. Older MSM were more likely to prefer less frequent reminders, whereas overseas-born MSM and PrEP users were more likely to prefer reminders every 3 months. Conclusions More than half of MSM accepted SMS reminders for syphilis testing, with most preferring 3-monthly reminders, consistent with recommended screening intervals. Differences in acceptance and preferred frequency by demographic characteristics could inform the implementation of tailored SMS reminders as part of the public health response to syphilis.