Eric Roland Director of Education Montrose Clinic Houston, Texas Developing, Designing and Disseminating a Syphilis Awareness Campaign Targeting MSM Eric Roland Director of Education Montrose Clinic Houston, Texas 4/17/2019 Montrose Clinic

Project Goals Increase awareness of syphilis signs & symptoms among MSM in Houston Increase awareness of the modes of transmission of syphilis Inform MSM about existing syphilis prevention, screening & treatment services in Houston and motivate MSM to utilize those services 4/17/2019 Montrose Clinic

Need for Campaign 200% increase in syphilis cases among MSM in an 18-month period (Jan 01-Jun 02) As much as 60% of those cases were in HIV-positive MSM Trend seen in other large urban areas in the United States, Europe 4/17/2019 Montrose Clinic

Development of Campaign Rapid community assessment Gain insight on high-risk MSM Analyze assessment Determine focus of campaign materials Conceptualize design ideas Write potential slogans/messages Sketch potential graphic designs 4/17/2019 Montrose Clinic

Rapid Community Assessment Snapshot of anonymous sex venues Utilized website www.cruisingforsex.com Identified over 70 anonymous sex venues Adult video stores, bathhouses, public parks/restrooms, fitness centers, internet Conducted site observations at venues Availability of condoms, lube, prevention info Description of surroundings and clientele 4/17/2019 Montrose Clinic

Rapid Community Assessment Administered short survey to MSM Conducted at 7 different locations Utilized outreach staff workers 94 surveys in a 2-week period Aimed to measure attitudes, knowledge, community norms, and risk behavior 28 questions long Anonymous and self-administered 4/17/2019 Montrose Clinic

Analysis of Assessment Survey Question #15 8% 21% 37% Syphilis is treatable and curable? 34% 4/17/2019 Montrose Clinic

Analysis of Assessment Survey Question #18 19% 20% Clear or milky discharge from the penis is a symptom of syphilis? 30% 31% 4/17/2019 Montrose Clinic

Analysis of Assessment Survey Question #11 8% 12% My friends always use condoms for anal sex. 36% 44% 4/17/2019 Montrose Clinic

Conceptualize Campaign 2 of 4 designs focused on behavior at anonymous sex venues Images needed to grab attention of men in sexually charged environments Slogans: “You think it always hurts to pee when you have an STD? Think again!” “You may get more than just a kiss behind closed doors! You may get syphilis” 4/17/2019 Montrose Clinic

Conceptualize Campaign 2 of 4 designs focused on all MSM Images needed to focus less on images, more on prevention messages Slogans: “Syphilis…take action, get tested, it’s free and easy” “What you should know about syphilis” 4/17/2019 Montrose Clinic

Testing of Preliminary Material Conducted focus groups “I really like the message” “I can relate to the message” “The information is useful to me” “Made me think about my own actions” “Images are appealing” Overall ratings ranged from 6.4 to 9.5 (10 point scale) Adjustments made to material based on results of focus groups 4/17/2019 Montrose Clinic

Campaign Review & Approval Unanimously approved by Clinic Program Materials Review Panel Reviewed and endorsed by both Houston HIV Prevention Community Planning Group and East Texas HIV Prevention Community Planning Group Unanimously approved by Texas Department of Health Program Materials Review Panel 4/17/2019 Montrose Clinic

4/17/2019 Montrose Clinic

Dissemination of Materials 11x17 posters – full color, gloss poster stock Print quantities (3 designs) 300 in Spanish; 600 in English Locations 2 bathhouses, 1 sex club, adult video stores, bars and clubs, retail stores, CBOs Timeframe – November 2002-current 4/17/2019 Montrose Clinic

4/17/2019 Montrose Clinic

Dissemination of Materials 4x6 maxi cards – printed on both sides, full color, gloss card stock Print quantities (2 designs) 10,000 in Spanish; 20,000 in English Locations 2 bathhouses, 1 sex club, adult video stores, bars and clubs, retail stores, CBOs Timeframe – November 2002-current 4/17/2019 Montrose Clinic

Dissemination of Materials 1x3 mini cards – printed on both sides, full color, gloss card stock Print quantities (3 designs) 2500 in Spanish; 7500 in English Used in condom packs, locations same as other plus special events (circuit parties) Timeframe – November 2002-current 4/17/2019 Montrose Clinic

4/17/2019 Montrose Clinic

Dissemination of Message Ran full-page cover advertisements in 5 different gay publications OutSmart – monthly magazine, Houston Texas Triangle – weekly newspaper, Austin/San Antonio/Dallas/Houston Houston Voice – weekly newspaper, Houston Q Texas – weekly entertainment guide, Austin/San Antonio/Dallas/Houston Eclipse – weekly entertainment guide, Atlanta/New Orleans/Houston 4/17/2019 Montrose Clinic

Outcome Indicators Increase in syphilis testing at Montrose Clinic 4/17/2019 Montrose Clinic

Resources Community Based Assessment: A Guide for HIV Prevention Workers by Kim Batchelor and Anne Freeman PDF available online at: www3.utsouthwestern.edu/preventiontoolbox Vilven Design Group, Houston www.vilven.com Bold Face Design, Los Angeles www.boldfacedesign.org 4/17/2019 Montrose Clinic