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.~ 9 <br />~ participant responses. The specific intervention strategies recommended for Guilford County <br />aze: _ <br />1. ~ Increase S'I'D, specifically syphilis, knowledge in the community. <br />2. Increase awareness of health department STD services. . <br />;. Increase'community-level and street outreach to the, affected communities. <br />4. Improve public health professionals' health education skills. <br />~. Promote and facilitate access to drug treatment. <br />6. Improve access to the at-risk population by collaborating with external partners (e.Q. <br />family planning, V~~IC, battered women shelters, jails, housing authority, drug <br />treatment, parks anal recreation) to provide STD information, screening, and treatment <br />services: <br />7. Increase mutually supportive and collaborative partnerships between and among <br />community-based organizations and the health department. <br />S. Conduct evaluations of existing prevention strategies. <br />Although developed for fiord County, the similarities of the syphilis epidemics in the five <br />counties lead us to believe that~these recommendations are excellent planning tools for this five- <br />county syphilis elimination project. <br />The health services available specifically for STDs in the five-county target area include one on- <br />site clinic in each county health depar~nent, open five days per week. In addition, serologic <br />testing for syphilis is currently performed by a small number of community-based organizations <br />in this area. Ek-tension of serologic testing services to better reach the population at high risk is <br />clearly needed and is one of the goals of this project. Partner notification services are provided <br />by ten DIS who serve this area; these staff aze responsible for all syphilis and HIS cases in their <br />area, but do not perfoim any follow-up for other STD cases.. Surveillance for STDs in the five- <br />county azea is largely passive. Occasional reminders are sent to private physicians to encourage <br />reporting. In addition, laboratory reporting of positive serologic tests for syphilis is legally <br />mandated and provides another route for identification of cases to the State. North Carolina does <br />not currently have any special surveillance azrangements to identify cases in jails, emergency <br />rooms, drug treatment centers, or other entities which servehigh-risk populations. . <br />~._-. <br />The local county health directors from this five-county area met in September, 1997 to discuss <br />the escalating syphilis epidemic in the area. In addition to pro~nding accessible and prompt STD <br />diaQn.asis and treatment, the group agreed ta: 1) designate an outbreak response team of 1-2 <br />. _ people from each county to assist other. counties in syphilis intervention when indicated by <br />morbidity, including worlan.g with the Section in RI.O.T. preparations and efforts when needed; <br />2) work with the Section to continue to facilitate communication and collaboration between local <br />health departments, CBOs and private providers; and ~) discuss syphilis and other STDs at the <br />regional health directors conference every quarter. The health directors have subsequently given <br />the syphilis elimination project, as outlined here, their full support. <br />~~ <br />4 <br />