Background: The City of Baltimore had the highest rate of syphilis in the country in 1997 but succeeded in reducing the rate annually until late 2003 when a syphilis outbreak connected to commercial sex activity occurred. A Community Outreach Program was initiated in September 2004 in conjunction with syphilis rapid response team assistance from CDC. The community screening was successful identifying syphilis and HIV and continued after the outbreak was contained. The STD/HIV Program reviews and responds to syphilis cases that use commercial sex workers. Five male syphilis cases in December 2007 and January 2008 revealed contacts with commercial sex workers in the Brooklyn neighborhood of south Baltimore. The Program instituted an immediate response.
Objectives: Prevent spread of syphilis by commercial sex workers
Methods: The program’s outreach vehicles were not available so a Community Based Organization with a mobile unit was asked to collaborate with an outreach event. The neighborhood was outside their catchment area but they agreed to assist. The mobile unit and a staff of ten DIS and Outreach workers recruited clients to be tested on January 31, 2008. All clients received syphilis and HIV tests and were given a five dollar gift card for participating.
Results: Thirty five clients were screened with four untreated female syphilis cases identified. One was determined to have secondary symptoms and two others were early latent. The other case was treated as a late latent due to no serology history or confirmed epidemiologic connection to early syphilis. All four cases reported periodic exchange of sex for drugs and money. Weekly screenings in the community for the following six weeks identified no additional cases.
Conclusions: Rapid response to outreach site information provided by syphilis patients can assist in identifying new syphilis and may help avert major syphilis outbreaks.
Implications for Programs, Policy, and/or Research: STD Prevention Outreach may effectively reduce syphilis incidence