California: "Not a Simple Answer" for Desert's Syphilis Problem

Despite a year of education and testing efforts, syphilis remains a serious public health problem in the Coachella Valley. As of the end of August, 73 syphilis cases were reported in Riverside County, compared to 78 during the same period for 2003. In both years, the majority of cases were recorded in the Coachella Valley. "We've considered it being at epidemic levels since 2002," said Barbara Cole, director of disease control in Riverside County and the lead official on the valley's syphilis outbreak.

While health officials say syphilis is being spread locally almost exclusively by gay men, many of whom are also HIV-positive, Cole said the disease is a county-wide public health issue, not just a "gay problem." "I wouldn't want the heterosexual community to feel like they're not at risk, because this is going to spread to other communities," said Robin Johnson, assistant director of social services for the Desert AIDS Project, the lead agency on the outbreak.

Riverside County reported just 25 syphilis cases in 2001. By 2002, 94 cases were logged, with the vast majority of them located in the Palm Springs area. As a result, the county health department launched a community-tailored campaign and stepped-up testing. In 2003, the number of cases in Riverside County rose to 105.

In April, the county formed the Syphilis Elimination Task Force to refine its safe-sex education campaign. "If people see the same [message] over and over again, it loses" impact, said Cole. DAP has added syphilis and other STD curricula to its community HIV/AIDS programs, said Johnson. The task force is also looking into partnering with other groups, such as local drug rehabilitation centers, on syphilis education. Experts agree that local health departments and DAP are doing virtually everything that can be done to stop the spread of syphilis in Coachella Valley: public education and testing.

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