Growing number of public health agencies turning to Internet to get out the word on STDs
CINCINNATI — As life moves to the Internet, a growing number of public health agencies are signing on to social networking sites — not to find friends but to fight syphilis, AIDS and other sexually transmitted diseases.
Public agencies in Ohio are among the latest to open accounts on online meeting sites in an effort to reach people who may have a sexually transmitted disease and need medical care.
Cleveland’s health department opened accounts on two sites this week, and Cincinnati has plans to start an online effort in a couple of months. Columbus Public Health established a presence a year ago on Manhunt, a social networking site for gay men, and has since added other popular sites.
Debra Mullen, who handles online notifications for Columbus Public Health, contacted a man a year ago who did not know he had syphilis. She heard from him again this week.
"He got treatment and now is asking whether he needs any follow-up," she said.
Traditionally, health departments have used letters and telephone calls to set up preferred face-to-face meetings with the partners of infected people who visit their clinics, test positive for a sexually transmitted disease, and reveal their partners’ names to health officials.
But with the Net, the encounters may occur between people who know only each other’s online names. Even with that small piece of information, health officials can go to the site, send a message to someone’s partner, and advise him or her to contact health officials and provide contact information.
Daniel Pohl of Howard Brown Health Center in Chicago recalls two instances where online notification has done more good than expected.
"One client I was in contact with over a couple of months was an escort. I was able to get him to come in for syphilis testing, and he was infected," said Pohl, the center’s manager of disease intervention services. "He was treated for that, but was too afraid to get tested then for HIV."
Over time, the man agreed and tested positive for HIV a year or so ago when he was 19, Pohl said. "He not only became very involved with his own care, but also got involved with a program that helps other young people with HIV."
Pohl said another man who lived with an emotionally abusive male partner was notified and tested negative for HIV and syphilis, but agreed to see a counselor in the center’s domestic violence program.
"Sometimes the person on the other end of the e-mail may be completely isolated from support services, and this may help them in many ways," Pohl said.
The National Coalition of STD Directors, consulting with the Centers for Disease Control and Prevention, developed guidelines in 2007 to help public health departments create profiles for confidential online notification. Health officials say the notification cost is minimal — a few thousand dollars for a computer and DSL line dedicated to the program.
Rachel Kachur, a researcher with the CDC’s STD prevention division, said she is encouraged more health departments are moving to online notification, but the work is not happening fast enough.
"The national guidelines help by giving local areas a jumping off point where they can tweak them to fit their needs," she said. "But the goal is to get everyone doing this."
Health departments in San Francisco, Washington, D.C., and Massachusetts were among the first to begin using social networks to reach a possibly infected person. The Web sites typically used cater to gays and bisexuals, such as Manhunt and Adam4Adam, but some officials hope to eventually reach the heterosexual population as well.
Cleveland, which has seen a rise in syphilis, started a presence on Manhunt and Adam4Adam this week, said David Merriman, project coordinator overseeing HIV/AIDS services for the city.
"Our goal is to also be on sites like Facebook where we could reach broader populations, including heterosexual adults and adolescents who wouldn’t use sites like Manhunt," Merriman said.
In Massachusetts, the state health department has reported a good response since initiating partner notification on Manhunt in 2006. Kevin Cranston, director of the department’s infectious diseases bureau, says well over 50 percent of those the agency contacted online responded, with some getting department-documented medical evaluation and treatment and others saying they would seek medical evaluation on their own.
On the Net: National Coalition of STD Directors www.ncsddc.org
This article appeared in the Dallas Voice print edition April 24, 2009.