Lessons Learned from Syphilis Elimination in Guilford County

Abstract

Guilford County, North Carolina has had a syphilis epidemic since 1994. Cofactors include crack cocaine use and the exchange of sex for drugs or money. The Guilford County Department of Public Health, and community-based organizations The Centers for Disease Control and Prevention and the North Carolina HIV/STD Prevention and Care Branch formed a partnership in 1997 dedicated to creating long-term solutions to the syphilis epidemic in Guilford County. A Rapid Ethnographic Community Assessment Process was conducted to explore the behavioral reasons behind the epidemic. Recommendations were made and are being implemented. Short interventions in targeted populations do not provide lasting solutions to community STD problems. Guilford County’s epidemic is a complex network of behavioral, environmental, and social factors. However, long-term partnerships between federal, state, and local health departments, in conjunction with community-based organizations, provide an infrastructure in which to implement lasting interventions that lead to community change.

Get full access to this article

View all access options for this article.

References

Alinsky, S. (1971). Rules for radicals: A practical primer for realistic radicals. New York: Random House.

Aral, S. (1999). The social context of syphilis persistence in the southeastern United States. Sexually Transmitted Disease, 23(1), 9-15.

Centers for Disease Control and Prevention . (1998, June 26). Primary and secondary syphilis—United States, 1997. Morbidity and Mortality Weekly Report, 47(24), 493-497.

Centers for Disease Control and Prevention . (1999a, June). The national plan to eliminate syphilis from the United States. Atlanta, GA: Division of STD Prevention, Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention . (1999b, September). Sexually transmitted disease surveillance, 1998. Atlanta, GA: Division of STD Prevention, Centers for Disease Control and Prevention.

Centers for Disease Control and Prevention . (1999c, December). Syphilis elimination report (SESR-52-Revision.0001). Atlanta, GA: Division of STD Prevention, Centers for Disease Control and Prevention.

Foust, E. (1994). North Carolina’s rapid intervention outbreak team. North Carolina Department of Health and Human Services Newsletter, 94, 7-7.

Freire, P. (1970). Pedagogy of the oppressed. New York: Heder and Heder.

Gabel, H. , Foust, E. , Ogburn, D. , Engel, N. , Owen-O’Dowd, J. , & Howerton-Privott, A. (1998). Outbreak of primary and secondary syphilis— Guilford County, North Carolina, 1996-1997. Morbidity and Mortality Weekly Report, 47(49), 1070-1073.

10.

Gibson, J. , Leverett, W. , & Arvelo, M. (1996). Providers of syphilis care in the southern United States. Sexually Transmitted Disease, 23(1), 40-44.

11.

Greensboro Corrections Department . (1998). Monthly crime reports. Available from Greensboro Police Department, 401 West Sycamore St., Greensboro, NC27401.

12.

Guilford County . (1995). Health status of Guilford County: Data book. Available from the Health Surveillance and Analysis Unit, Guilford County Department of Public Health, 301 North Eugene St., Greensboro, NC27401.

13.

Guilford County Department of Public Health . (1999). Guilford County health data book. Available through the Guilford County Department of Public Health.

14.

North Carolina Department of Commerce . (1998, February 16). County ranking profiles. Retrieved from http://www.ospl.state.nc.us/osplbin/crpmain.cgi/response

15.

North Carolina Department of Health and Human Services HIV/STD Prevention and Care Branch . (1998). STD monthly reports. Available from North Carolina Department of Health and Human Services HIV/STD Prevention and Care Branch, 1915 Mail Service Center, Raleigh, NC, 27699-1915.

16.

Sutton, M. (1997). EPI-AID #97-80 trip report:Outbreak of early syphilis, Guilford County, NC, 1996-1997. Available from Epidemiology and Surveillance Branch, Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333.

17.

Tashima, N. , Crain, C. , O’Reilly, K. , & Elifson, C. (1996). The community identification process: A discovery model. Qualitative Health Research, 6(1), 23-48.

18.

Thomas, S. , & Quinn, S. (1991). The Tuskegee syphilis study, 1993 to 1972: Implications for HIV education and AIDS risk reduction programs in the Black community. American Journal of Public Health, 81(11), 1498-1505.

19.

Valentine, S. & DeAguerro, L. (1995). Defining the components of street outreach for HIV prevention: The contact and the encounter. Public Health Reports, 3,(Supp 1), 69-74.

20.

U. S. Census Bureau . (2000). U. S. Census 2000 population estimates for North Carolina. Available thorugh www.census.gov.