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.