Discreetly Tracking Down Sex Partners To Stop A Surge In STDs
September 8, 2018
Heard on Weekend Edition Saturday
Kristian Foden-Vencil
The U.S. is in the middle of a steep and sustained increase in sexually transmitted diseases.
So how are public health officials responding?
In northwest Oregon's Clackamas County, health officials have decided to ask anyone who comes in with anSTD who their sexual partners are — and then track those partners down.
That job falls to two women: registered nurse Mary Horman, and disease intervention specialist Liz Baca. They do most of the work over the phone, telling people they've had a partner (no name is revealed) who has tested positive for gonorrhea, HIV, chlamydia or syphilis.
It's a difficult conversation. And many people can't be reached via phone. So about once a week, Horman and Baca jump into a car and start knocking on doors.
"It can definitely be scary at times," Baca says, "especially those rural areas where you're really relying on the GPS to get you there, and sometimes there are roads that lead you to nowhere." So far, they haven't gotten lost.
Plenty of residents in the county's outskirtsown firearms, Baca says, and are comfortable displaying them if they feel they need to protect their property.
"I always try to make myself visible and not be fidgety," she says. Baca tries to make her approach as warm as possible, and says, " 'I have a nurse with me.' Or, 'My name is Liz, and I work for Clackamas County.' "
The two always travel as a pair, and never enter a home, she says. And they always carry a cell phone to keep the home office informed of their whereabouts.
On the afternoon I catch up with them, Horman and Baca already have been challenged by a dog and had to leave a trailer park empty-handed. They had the right spot, but didn't know which door to knock on. And they couldn't just ask around, because neighbors might guess why the health department is tracking someone down, and that would be a breach of medical privacy.
They next call on a 64-year-old laborer, who we're just identifying as Larry for those same privacy reasons. He agrees to talk with them, in hopes of warning other people about the substantial
risks of syphilis.
Baca and Horman tell him how some diseases, like syphilis, are "
reportable" — meaning that as soon as Larry was diagnosed, the doctor had to inform the county, which is why they're at his door.
Larry tells them he's already had penicillin delivered intravenously, and he's healing fine.
The conversation gets tougher as Baca tries to understand the extent of Larry's infection by showing him graphic pictures of sores and rashes.
"So, another symptom of secondary syphilis is the loss of hair," she explains. "So, you suddenly lose some hair. You're thinking, 'What's going on?' In a couple of weeks it resolves. And you're still infected. So do you recall any of these symptoms?"
Also, the fact that the disease was, for a time,
nearly eradicated in much of the United States
, means some younger doctors don't readily recognize the symptoms and signs.
Larry explains that he used to have sex with multiple partners he found on Craigslist. But he can't remember any names.
Baca is crestfallen. After such a long time, it's too late to track down those people.
Still, she insists her time wasn't wasted.
"Being out in the field, you find individuals and you get that public health intervention that is crucial," she says.
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Originally Posted by TheCount
She may look clean but. . . : The sexual proclivities of soldiers, who were often lonely as they traveled far from home, played a major role in the spread of STDs in the 1940s
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