Background:
The South Florida Syphilis Coalition (SFSC) was established in fall 2003 to carry out a social marketing campaign that would address an unexpected upsurge in infectious syphilis cases among men. Goals of the campaign were: (1) increase awareness and knowledge of syphilis, (2) promote protective and reduce risky sexual practices, and (3) encourage testing and treatment.

Objective:
To assess the short-term effects of the campaign on men who had sex with men (MSM), we conducted a baseline and six-month follow-up survey of adult residents of Broward and Miami-Dade counties, Florida.

Method:
Anonymous, 12-page, self-administered questionnaires were distributed to > 400 MSM recruited from ten diverse central locations of south Florida in February-March and > 400 MSM again in October 2004. A 12-item test of knowledge was developed based on a CDC Fact Sheet about syphilis in MSM. Cross-tabulations of dichotomous variables were examined for statistical significance using Pearson's Chi-square.

Result:
The two samples were similar with respect to age, race/ethnicity, educational attainment, and employment status (p>0.05). Exposure to one or more SFSC marketing materials increased from 18.0% in spring to 36.5% in fall 2004 (p<0.001), but knowledge about syphilis failed to improve. Increases in exposure to radio, television, and newspaper announcements about syphilis occurred among Broward—but not Miami-Dade—residents. No decreases in risky sexual practices, no increases in testing, and no increases in treatment for syphilis were observed. The campaign ended in December 2004. The Coalition disbanded when funding ceased.

Conclusion:
After six months of implementation, none of the social marketing campaign objectives was fully met. Awareness of the problem increased, but there was no evidence of increased knowledge, decreases in risky sexual practices, or increases in testing for syphilis.

Implications:
Interventions designed to promote STD prevention in vulnerable populations require adequate funding, sustained implementation, and long-term support.