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Potential for Community-Based Screening, Treatment, and Antibiotic
Prophylaxis for Syphilis Prevention.
Sexually Transmitted Diseases 2000;27(4):188-192.
Kahn RH, Moseley KE, Johnson G, Farley TA.
Abstract
BACKGROUND: The recent syphilis epidemic in Louisiana occurred predominantly
among disadvantaged African Americans who may distrust public health agencies
and prevention efforts. OBJECTIVES: To determine community perceptions regarding
trust and use of public health clinics, to assess whether race of provider
is important to persons at risk for syphilis, and to assess the willingness
of persons to participate in syphilis screening, treatment, and antibiotic
prophylaxis. STUDY DESIGN: Qualitative interviews were conducted with 18
community leaders and 38 community members who were at risk for syphilis.
Quantitative surveys were completed by persons with primary or secondary
syphilis (n = 92), their sexual contacts (n = 56), and with neighborhood
controls (n = 143). Three possible programs for syphilis screening and antibiotic
prophylaxis were proposed (1) bar setting; (2) home setting, and (3) mobile
health-van setting in high-risk communities. RESULTS: In qualitative interviews,
community leaders and community members reported a high degree of trust in
the public sexually transmitted disease clinic. A majority of respondents
felt that race was not a factor in choosing healthcare providers. Respondents
favored the provision of services in a mobile health van over in a bar or
in their homes. In quantitative interviews, more than 80% of community members
surveyed reported that they would go to a mobile health van for syphilis
testing. Nearly two thirds of respondents reported that they would be willing
to take oral prophylaxis for syphilis, and more than half of respondents
reported that they would accept an injection. CONCLUSIONS: Community members
trust the public sexually transmitted disease (STD) clinic, are generally
not concerned with the race of healthcare providers, and are supportive of
community-based STD screening, treatment, and antibiotic prophylaxis provided
from a mobile clinic.