There is a significant history of the study of syphilis in the United States, perhaps most notably the infamous Tuskegee experiment that began in 1932(CDC, 2009).The U.S. Public Health Service conducted this 40-year study of 600 poor black sharecroppers living in Macon County, Alabama, 399 of whom had late-stage syphilis; 201 were uninfected control subjects. These men, their spouses, and their children were not told what disease they had, nor were they treated. Instead, from 1932 until the story had leaked to the Associated Press in 1972, researchers gathered data on the progression of their illness through clinical examination, spinal tap, blood testing, and autopsy; no formal protocol had ever been devised. When penicillin became available in the 1940’s, the test subjects were deliberately denied it. By the time the study was stopped, syphilis had killed 28 of the men directly and 100 through complications. Forty wives had been infected and 19 children had been born with syphilis. After the Tuskegee experiment came to light, The National Research Act was signed into law, requiring the establishment of institutional review boards to oversee all biomedical and behavioral research involving human subjects.

How can we reduce the rise of syphilis in the gay population? MSM need to be educated about the dangers of Syphilis, and screened, tested and treated. But what if they don’t come into the clinic? One innovative way to reach MSM is outlined in an article in the Journal of the American Sexually Transmitted Disease Association. According to Blank, et al (2005), this method, the Hot Shot! Healthy Men’s Night Out Program, was a New York City based program designed with a field-based holistic approach to MSM health and wellness. The medical experimenters, with the help of their internal and community partners developed a modest package of “transportable” interventions specific to the morbidity and mortality documented in the neighborhoods most affected by syphilis. These interventions included general screening services (hypertension, diabetes, drug abuse, depression), diagnostic services (HIV, syphilis, gonorrhea, and chlamydia testing), and referral services (tobacco cessation, crystal methamphetamine counseling).They offered their package of services in nontraditional venues such as bars and clubs, specifically those identified through their syphilis case interviews. When possible, they integrated these services with scheduled social events at the venues. The idea was to bring essential health care services into a nonmedical social setting in order to attract MSM who might not otherwise have sought out such services.

Niagara County offers a range of services for prevention and treatment of Syphilis and other sexually transmitted diseases. The Niagara County Department of Health holds STD clinics every Monday and Wednesday (except on national holidays) from 10:00 A.M. to 3:30 P.M. The clinic is located on the first floor of Trott Access Center, 1001 – 11th Street, Niagara Falls, NY. Specialized staff provides counseling, education and testing for STD’s and HIV. Services are confidential and free of charge. To learn more about STD’s, including HIV, visitwww.nyhealth.gov. For more information about STD testing, contact the Niagara County Department of Health at (716) 278-1900 or visit www.niagaracounty.com/health/Nu_transmitted.asp. To find other testing sites in your area, visit www.hivtest.org. Additional information and activities for the 2009 STD Awareness Month can be found online at www.cdcnpin.org/stdawareness.

Khalifah Glover, RN is a practicing nurse and student at the State University of New York at Buffalo in the RN to BS program. This article was written while on clinical assignment at the Niagara County Department of Health.  

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