Background:
In 2003, 43/267 (16%) of all primary and secondary syphilis (P&S) cases in Chicago were diagnosed at Howard Brown Health Center (HBHC), a lesbian, gay, bisexual and transgender (LGBT) community health center. Beginning in 6/2002, HBHC employed a Disease Intervention Specialist (DIS) to conduct case management of all syphilis cases treated at HBHC.

Objective:
To evaluate the efficacy of this program.

Method:
A retrospective case audit compared outcomes of HBHC DIS-managed cases with those managed by CDPH DIS, who provided case management before 6/2002. Cases of early syphilis diagnosed and treated at HBHC between 1/2000 – 12/2003 were analyzed.

Result:
Of 232 cases reviewed, HBHC conducted 124 (53.4%) investigations; 108 (46.6%) were conducted by CDPH. Of CDPH managed cases, 43 (39.8%) were lost to follow-up, compared to 6 (4.8%) of HBHC cases (p<0.01). Of the remaining 183 cases, the median number of days between treatment and interview was 26 for CDPH and 1 (one) for HBHC. DIS from CDPH elicited at least one partner in 29/108 (26.9%) cases, compared to 63/124 (50.8%) for HBHC DIS (p<0.01). Of 191 sex partners elicited, 50 (26.2%) were elicited by CDPH DIS and 141 (73.8%) by HBHC; partner index (elicited partners/cases interviewed) was 0.463 for CDPH and 1.14 for HBHC. There were 13 infected sex partners treated, two (15.4%) by CDPH and 11 (84.6%) by HBHC; and 63 sex partners possibly in the incubation period who received preventive treatment, nine (14.3%) by CDPH and 54 (85.7%) by HBHC.

Conclusion:
The productiveness of the HBHC DIS suggests that collaborations between community health centers and health departments can provide an effective alternative to traditional syphilis case investigation and partner notification.

Implications:
Whether the success is related to more timely interventions or culturally appropriate interviewing techniques should be further studied.