The 130th Annual Meeting of APHA

Abstract #42267

Lori Leonard, ScD, Bloomberg School of Public Health, The Johns Hopkins University, Department of International Health, 615 North Wolfe Street, Room E7142, Baltimore, MD 21205 and Robert Fisher, PhD, Urban and Community Studies, University of Connecticut, 1798 Asylum Ave, West Hartford, CT 06117, 860 570-9298, lleonard@jhsph.edu.

The public health response to sexually transmitted infections (STIs), a major problem in the United States, has shifted over time, mirroring broader trends in the field. Following World War II, the federal government played a key role in responding to epidemic levels of STIs. Since that time, responsibility for prevention and control efforts has increasingly shifted to states, to local communities, and to individuals. STIs have become a private rather than a public preoccupation. In this paper, we use a community-based syphilis prevention project in Houston to illustrate the implications of the trend toward the privatization of public health. The project, which ran from 1995 to 2000, created a network of approximately 40 business owners in an inner-city neighborhood (population 30,000) that distributed prevention materials and displayed educational messages. While successful by some measures, the project was not sustainable; the network ceased to function shortly after funding for the project and centralized support to the businesses ended. Drawing on lessons learned from this experience, we explore how historical, political, and social currents have converged to shape a private world, of which Houston is an example par excellence, that pushes public health promotion into the private sector and is often inhospitable to a truly public health. We also detail the limits of promoting public health in private, albeit community-based, spaces. At the same time, the project suggests ways in which the public can be re-imagined and re-engaged around issues of community health and well-being, even in this very private time.

Learning Objectives:

• Describe the relative magnitude of the problem of STIs in the United States;
• Examine the history of public health responses to STIs and their prevention and control in the United States;
• Recognize some of the ways in which historical, political, and social trends have contributed to the privatization of STI prevention and control and to the privatization of public health;
• Assess constraints to conducting public health campaigns in communities through the private sector;
• Discuss ways of re-conceptualizing and re-engaging the public around issues of community health in a private era.

Keywords: Community Outreach, STD Prevention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.