“The Clap Doctor”, “The Father of Spin,” and Other Historical Lessons

for Syphilis Elimination

Bill PetzNorth Carolina HIV/STD Prevention

and Care Branch

Treponema

“What Will My Future Be Like?”

“Syphilis Elimination: History in the Making”

• “Current STD prevention & control not sufficient”

• “New strategies required”

• “Combining intensified traditional approaches with innovative approaches can generate new synergy and enhance effectiveness”

Five Strategies

• Enhanced surveillance

• Enhanced health promotion

• Expanded clinical and laboratory services

• Rapid outbreak response*

• Strengthening community involvement and partnerships*

*”new in many parts of US”

Community Involvement and Partnerships

• “acknowledges and responds to the effects of racism, poverty, and other relevant social issues on the persistence of syphilis”

• Other: Sexism, homophobia, substance abuse, stigma, distrust of government, privacy, confidentiality, prostitution

• Still other: political will, moralistic judgment, …….

Not successfully included in past efforts to eliminate syphilis

• Consideration of the social context in which syphilis persists

• Affected communities and the agencies that serve them

Requirements for Success

• Commitment, investment and collaboration of opinion leaders and program managers

• Members and leaders of affected communities involved in design and delivery of services and shared ownership of interventions

History Already Made

Edward Bernays1891-1995

“Father of Public Relations”

• Nephew of Freud• Selling of WW I & II• Women’s smoking• Fluoridation of water• “engineering of

consent”

Edward Bernays

• Medical Reviews of Reviews 1912

• Play “Damaged Goods”

• Support actor Richard Bennett’s goal to produce the play

• “Sociological Fund Committee” prominent membership and funding to educate public on STDs

Damaged Goods

• Opened in NYC on Broadway March 1913

• Rave reviews for open discussion (not for the drama or acting)

• Presented in Washington for government leaders April 1913

• Support from the powerful for value of the message

Dr. Ben Reitman1879-1942

“The Clap Doctor”• Born in poverty• “King of Hobos”• Lover and manager for

Emma Goldman• Birth control advocate• Sociological studies• Numerous affairs

Ben Reitman

• Cook County Remedy Company

• 1917 established Chicago’s first VD clinic

• 1922 Chicago VD campaign

• 1923 County jail & House of Detention Clinics established

• 1924 Prevention information to 500,000 homes; 1937 syphilis testing survey

• 1937 Chicago Syphilis Control Project

Chicago Syphilis Control

• One million tests in 2 years

• Half of elementary school children tested

• 42,000 cases found• 20% of African

American tested were infected

Chicago Syphilis Control

• Reitman creates Chicago Society for Prevention of VD

• 100 talks in 2 years

• Takes leaders to high morbidity areas

• Takes disenfranchised to churches, schools

• Special Investigator for Project

Ben Reitman

• Advocates for full and accurate information

• Promotes barrier prevention rather than “moral prophylaxis”

• Predicts condoms will be available in schools

• Challenges authorities and fired

National Efforts

• 1937 Surgeon General Parran’s program

• Explicit public support from President Roosevelt

• Collaboration with states, cities, community groups, business, churches

• “bad blood war wagon”

• Dr. Vanderlehr’s assessment

New and Innovative

• Social marketing• Media advocacy• Mobile units• Jail and prison

screening

• Public opinion leaders• Faith based initiatives• Community advocacy

New synergy

• ‘acknowledges, and responds to the effects of racism, poverty, and other relevant social issues on the persistence of syphilis” AND WORKS TO ELIMINATE THEM

• Treats quality health care and health disparities as a justice issue

• Broadens the concept of moral issues

Treponema

“What Will My Future Be Like?”

Bill Petz

• 828 669 3350

• Bill.Petz@ncmail.net

• Menshealthnc@mail.com