The Impact of Prostitution and Drugs on a Rural Syphilis Outbreak

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The Impact of Prostitutionand Drugs on aRural
Syphilis Outbreak

• Evelyn Foust, MPH
• Judy Owen-ODowd
• April Locklear-Oxendine

• Connie Jones
• Peter Leone, MD
• Rhonda Ashby

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Early SyphilisRobeson County versus North
Carolina
02/02 HIV/STD Prevention and Care Branch
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37 Decrease in Primary and Secondary 1998 - 2001

• Increased DIS Staff
• Targeted DIS efforts into HMAs
• Developed Community based projects
• Enhanced local health department
• Jail screening
• Actively used NCs Outbreak response plan

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SMART RIOTOUTREACH SCREENINGRESULTS

• 1,124 residents received education/outreach
• 728 were screened for syphilis
• 31 positive bloods found
• 15 (48) were new cases
• 16 (51.6) were previous cases
• 484 (66) agreed to HIV screening
• 1 new HIV case and 1 previous HIV case

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CHALLENGES INROBESON COUNTY

• Rural Area
• Prostitution
• Transportation
• Locating Clients
• Unemployment and Poverty
• Drugs
• Cultural Diversity

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RAILROAD TRACK
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CRACK DITCH ENTRANCE
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INSIDE CRACK DITCH
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CRACK/SEX HOUSE
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NEW CHALLENGES

• ENHANCE THE AVAILABILITY OF CULTURALLY
• RESPONSIVE PRIMARY CARE INCLUDING PSYCHOSOCIAL
  SERVICES TARGETING WOMEN
• More outreach activities 24/7
• Multilingual disease education
• Risk reduction counseling
• Holistic health assessment
• HIV/STD screening and treatment
• Substance abuse mental health treatment
  referral