title: Potential for community-based screening, treatment, and antibiotic prophylaxis for syphilis prevention.
abstract: BACKGROUND
  The recent syphilis epidemic in Louisiana occurred predominantly among disadvantaged African Americans who may distrust public health agencies and prevention efforts.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Louisiana Office of Public Health, New Orleans, USA. rhk0@cdc.gov
authors.forename: R H
authors.initials: RH
authors.lastname: Kahn
authors.forename: K E
authors.initials: KE
authors.lastname: Moseley
authors.forename: G
authors.initials: G
authors.lastname: Johnson
authors.forename: T A
authors.initials: TA
authors.lastname: Farley
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D019072:Antibiotic Prophylaxis; D003153:Community Health Services; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008145:Louisiana; D008297:Male; D008403:Mass Screening / Q000523:psychology; D008875:Middle Aged; D008952:Mobile Health Units; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000517:prevention & control*; D044465:White People