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P32 Rapid Outreach Response to Social/Sexual Network Information Provided During Syphilis Interviews

Wednesday, March 10, 2010
Pre-Function Lobby & Grand Ballroom D2/E (M4) (Omni Hotel)
Phyllis Burnett, BA, STD/HIV Prevention Program, CDC and Baltimore City Health Department, Baltimore, MD, Glen Olthoff, MSHS, Centers for Disease Control and Baltimore City Health Department, Baltimore, MD, Denise Freeman, MS, Division of STD Prevention, Centers For Disease Control, Atlanta, GA, Michelle Joe, BS, Bureau of STD/HIV Prevention, Centers for Disease Control and Baltimore City Health Department, Baltimore, MD and Pat Letke-Alexander, MS, PA, Care-A-Van Outreach, Johns Hopkins Bayview Medical Center, Baltimore, MD

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

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