The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #63128

Paula Amezola De Herrera, MPH, Sexual Health Program, Los Angeles Gay & Lesbian Center, 1625 N. Schrader Blvd., Los Angeles, CA 90028, (323) 993 -7549, pamezola@laglc.org and David Anderson, MD, HIV / Family Practice, Tower I.D. Medical Associates, 8631 W. Third Street, Suite 1015E, Los Angeles, CA 90048.

OBJECTIVE: We investigated possible behavioral health determinants involved in the ongoing three year syphilis outbreak. METHODS: The L.A. Gay & Lesbian Center, a sentinel site for the Los Angeles County STD department, offers screening and treatment for numerous STD’s. Additionally, we collect sexual-behavior information to monitor the health status of this population. We utilized reactive RPR and TPPA tests and previous history to declare a new syphilis infection. Analysis of the surveillance data (N= 99) was done with simple descriptive techniques. RESULTS: From January 2001 through December 2002, 3787 RPR tests were performed with 177 reactive results (78 previously treated infections and 99 new infections). Of the new cases, 73% reported ever having an STD (21% within the past year.) When asked about the sexual history of their partners, 40% of the patients had contact with an HIV positive person, and 11% had contact with an injection-drug user. The patients also reported the number of partners, in the last 6 months it ranged from 0-600 (median = 4,) and in the last 30 days it ranged from 0-30 (median = 1.) In regard to their last sexual encounters, 51% of those surveyed did not use a condom for anal sex, while 90% did not use one for oral sex. CONCLUSIONS: Our findings suggest the local MSM population continues to practice high risk sexual behavior. Thus, sexual health prevention services need to be revisited; innovative efforts and widespread dissemination of these will be required to put a halt to this outbreak.

Learning Objectives:

• This presentation will briefly describe the Sexual Health sentinel surveillance program at the Los Angeles Gay and Lesbian Center. We will explain how the data we have collected has been used to inform the responsible public health authorities and the general public of possible elevated STD rates in this specific population and the limitations associated with sentinel surveillance data. In addition, we will present the ongoing syphilis outbreak and the natural history of disease. Special attention will be given to the demographics and high risk behaviors feeding the outbreak. One population most affected by the syphilis outbreak has been the MSM community and the impact will be discussed. Strong efforts to abate the syphilis outbreak have been implemented with the “Stop the Sores” campaign, which created the collaboration between Los Angeles County Department of Health Services, AIDS Healthcare Foundation, AIDS Project Los Angeles, Asian Pacific AIDS Intervention Team, Bienestar, Los Angeles Gay and Lesbian Center, and Minority AIDS Project. Finally, we will talk about the case management system we have implemented to follow syphilis progression and appropriate drop in titers in patients.
• • List the differences between research and surveillance.
• • Recognize the importance of analyzing and reporting the routinely collected data in a surveillance system
• • Describe the key attributes of the Sexual Health Program’s sentinel surveillance
• • Learn some basic syphilis information
• • Define the demographics and high risk behaviors feeding the outbreak
• • Understand the degree to which the syphilis outbreak has impacted the MSM community
• • Raise awareness to improve prevention efforts and their dissemination
• • Learn about the fighting efforts we have incorporated in our clinic

Keywords: Syphilis Screening, Surveillance

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.