1. Anonymous Sex Venues for MSM: Implementing Outreach Screening for Syphilis and HIV at Adult Bookstores Barbara Collins & Ana Alvarez Houston Dept. of Health & Human Services Brent Pendleton - Montrose Clinic

2. Bookstore Outreach Pursuing opportunities to reach at-risk persons through screening in anonymous sex venues

3. Identifying the Need for Bookstore Outreach 35 yr.old Hispanic Male, Single, MSM Diagnosis: Secondary Syphilis at HDHHS STD clinic Co-infection: HIV positive since 1996 Partners: multiple anonymous sex partners at an adult bookstore Provided name and location of adult bookstore

4. Implementing Bookstore Outreach Implementing Bookstore Outreach Identify venues through case management activities Make visits to venues to meet with managers/owners Negotiate days/times for conducting outreach in venue Identify resources for screening- staff needed Collaborate with CBO partners - Bread of Life and Montrose Clinic

5. Bookstore Outreach Screening at 1st bookstore began in March, 2003, 1 day a week Screening at 2nd bookstore began in April, 2003, 1 day a week Began screening in July, 2003 at 3rd and 4th bookstore. Patrons Primarily Male White and Hispanic All ages

6. Collaboration is the Key Adult bookstores not responsive to testing in past years by Montrose Clinic HDHHS secures bookstore for screening HDHHS seeks technical assistance from Montrose Clinic Health Educators conduct MSM 101 for DIS staff

7. Tailoring Techniques for MSM Montrose Clinic Health Educators are specialists in their own business Wide range of races, ethnicities, ages and subcultures, knowledge and beliefs Differences in social networks and sexual practices Questioning sexuality, multiple anonymous partners, sexual addiction, substance use, depression

8. Bookstore Outreach Face to face encounters All patrons offered confidential testing for Syphilis & HIV Condoms distributed Materials distributed to increase syphilis awareness and encourage prevention HDHHS press releases Brochures Incentives provided

9. Screening Results March - December, 2003 286 Persons screened for Syphilis & HIV 11 HIV positives 4 White Males & 7 Hispanic Males 8 new cases & 3 previously reported All counseled and referred for services 10 Syphilis reactors- 1 previously treated 9 infected and brought to treatment