Enhanced Syphilis Partner Services in a Community Health Setting; Collaborative Strategies for Public Health Advisers

Background: Public Health Advisors (PHAs) play a vital role in comprehensive syphilis elimination efforts through investigative contact epidemiology, partner elicitation, patient education, and risk-reduction counseling. Historically PHAs are situated in state and local health departments. The National Plan to Eliminate Syphilis underscored the need for alliances with organizational partners, including involvement of community health centers (CHC) and other agencies in provision of culturally competent interventions for persons at highest risk.

Objectives: This presentation will illustrate the successful implementation of the PHA role in a CHC setting.

Project Description: Callen-Lorde (CLCHC), a CHC that serves primarily lesbian, gay, bisexual, and transgender individuals, reports the second highest incidence of primary and secondary syphilis in NYC. In November of 2010 the CDC, in conjunction with the NYC Department of Health and Mental Hygiene (NYCDOHMH), funded the placement of two onsite PHAs to develop and implement a program to provide culturally competent education and partner services targeting syphilis, especially among MSM.

Findings: From March to September 2011, the PHAs interviewed clients at CLCHC, often on the same day as their syphilis diagnosis. Partners were identified in 61% of interviews conducted. In addition, the contact index of the program (number of partners elicited divided by number of patients interviewed) was 2.02, more than double the rate obtained by NYCDOHMH STD staff. Patients unwilling or unable to disclose partner names, most patients provided demographic and risk factor surveillance information. Of the interviews conducted at CLCHC, 95% were MSM.

Conclusions: Syphilis elimination efforts were enhanced by training community health center employees hired for PHA work. The collaboration allowed for improved integration with primary care services, provided rapid access to culturally competent and appropriate education and risk-reduction services, and increased the success rate of partner elicitation.

Implications for Programs, Policy, and Research: PHA programs implemented in community health center settings have the potential to enhance syphilis elimination interventions.