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11 <br />a) By January, 1999, all community-based organizations offering HIV counseling and <br />- testing in the five-county area will offer and encourage syphilis serologic testing to <br />clients requesting HIV tests. ~ - <br />b) By May, 1999, each outreach worker will provide weekly risk-reduction sessions at the <br />Local jail, provide one-on-one outreach to individuals. at risk for syphilis in the <br />community for 8 hours per week and document the establishment of condom distribution <br />sites which are accessible to at-risk persons. <br />c) By June, 1999, the new RI.O.T. team led by the project coordinator will be ready to <br />mobilize when needed for new outbreaks. <br />d) By September, 1999, 7~% of indi~riduals who are in local jails more than 24 hours will <br />receive a serologic test for syphilis. <br />6. Evaluate the achievements of the syphilis~elimination praject through its impact on reported <br />primary and secondary syphilis morbidity, with a goal of s I ~ cases/100,000 population in the <br />five-county target area in the year 2000 (rates in 1997 were 26.2 cases/100,000}, and on <br />prevalences of syphilis in local jails, health department prenatal~clinics, and health department. <br />STD clinics. Specinc goals will depend on baseline prevalences, which are not currently known. <br />METHODS <br />1. Community Assessment <br />North Carolina will request that CDC allow a federal employee (GS-12) who is currently <br />assigned to the state to become a special projects of"ncer for the project This individual will <br />coorainate and provide direct oversight to the project, and develop and implement data collection <br />for project evaluation. The community assessment teams will be comprised of the project <br />coordinator, a county health educator and a local DIS in each county; teams will conduct rapid <br />community assessments in the high morbiaity arras of Forsyth, Alamance, Orange, and Durham <br />Counties. The rapid community assessment tool developed by Jo Valentine (CDC) and <br />implemented recently in Guilford County will be used.. State and local DIS have demonstrated <br />their ability to successfully perform this assessment in Guilford County. Information on syphilis <br />clinical services available in each county v~~ill be collected by the coordinator, assisted by local <br />DIS. This information will include availability and utilization of syphilis screening in local jails <br />and drug treatment centers. These assessments will allow characterization of the local population <br />at high risk for syphilis, local factors promoting syphilis transmission, and local barriers to <br />syphilis clia Gnosis, treatment, and prevention. Data analysis will be assisted by state and federal <br />start familiar with epidemiologic analyses. <br />Each county's surveillance system for syphilis will be evaluated by the project coordinator and <br />~. ,~„ Local DIS, assisted by state staff. This evaluation will include assessing the sensitivity of the <br />current system by contacting local clinical service providers that serve high-risk populations and <br />6 <br />