Background:
An estimated 2 to 3 million people are homeless in the U.S and many of these individuals practice high risk behaviors.

Objective:
To evaluate a C-POL (Community Popular Opinion Leader) based syphilis prevention intervention developed in partnership with community-based organizations can be delivered to individuals seen at missions in two Alabama cities.

Method:
Behavioral and biological assessments for syphilis, gonorrhea, chlamydia, and HIV were conducted at baseline and 6 months. The intervention identified, recruited, and trained 15% of the mission population (n=30) as C-POLs in City 2 (treatment group) to deliver syphilis prevention messages to other mission clients.

Result:
After 6-months, more individuals in the treatment city (N=202) reported they had seen our project logo (54.6% vs. 5.0%), had heard something about syphilis in the last 6 months (37.4% vs.11.4%) and, in the last 2 months had at least one of our trained interventionists talk with them about syphilis (34.2 vs. 7.0%) (all p-values <.001) as compared with controls (N=202). Although no significant differences were found for consistent condom use or STI prevalence across the populations from the two cities, more individuals in the treatment city reported that they were seriously contemplating using condoms consistently with their main partners within the next 6 months than controls (53.0% vs. 37.0%; p=.005).

Conclusion:
These findings suggest that C-POL interventions developed in partnership with community based organizations can increase syphilis awareness and that trained mission clients can successfully disseminate sexual health information.

Implications:
The findings suggest that syphilis intervention messages can be diffused by trusted individuals within this and other hard to reach populations.