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Men at Work
This could be “reality TV” in the new fall line-up for HBO – two heterosexual
guys have suited up to do syphilis prevention work in Detroit’s gay bathhouses.
Who are these men? Mark Peterson (yes that same Mark Peterson you’ve seen on the
frontlines of this epidemic for years, currently prevention specialist at MAPP)
and Anthony Harris, a disease intervention specialist, for MDCH-DHAS at the
Detroit Health Department (DHD). Last year Harris also began working with the
CDC directed DHD syphilis elimination team.
Last fall, Peterson, Harris and MAPP CEO Craig Covey began the preliminary work.
They identified certain areas; bars, parks and ‘health clubs’ – gay bathhouses,
to target for syphilis/HIV prevention outreach work. There are several ASO/CBO’s
who are collaborating on the MSM syphilis project, including Community Health
Awareness Group (CHAG) and Arab Community Center For Economic and Social Service
(ACCESS).
MDCH provided the syphilis training for the outreach workers who now go to the
identified locations for prevention work offering information, condoms, and free
testing. Harris is certified to provide both syphilis and HIV testing. It took
until April 2003 to get the go ahead from the ‘health clubs’ to come in and do
the prevention and testing.
Peterson and Harris, who previously worked together doing HIV outreach for the
AIDS Consortium of Southeast Michigan (ACSEM), now go as a team to the
bathhouses, sometimes accompanied by an outreach worker from ACCESS.
“We’re getting out there and identifying the population, but it doesn’t seem
they are being very receptive,” said Harris. “They get the information, but they
won’t accept the tests. A lot of them say they would rather go to their private
physicians. They don’t want to have the stigma of going to Herman Kiefer” to get
test results for HIV and treatment for syphilis. “We have to warm up to them,”
added Harris. “We let them know (testing) is available to them whenever they
want to do it.”
Many of the men who come into Detroit for these MSM venues are coming from
Oakland County, noted Harris. MAPP actually initiated the bathhouse outreach
program at the request of MDCH and the Oakland County Health Department's HIV
and STD sections. They had learned from clients that some exposures might have
taken place at the bathhouse locations. Outside of Detroit, Oakland County had
the most reported cases of primary and secondary syphilis last year (2002).
When they go to the bathhouses, Harris said he thinks the men feel that he and
Peterson are invading their privacy. They are there “to have a good time” and
this is just too much reality in their face. Even though the bathhouse
management provides a private room for Harris to draw blood for the testing, the
men do not take advantage of this service. “So I leave the information there and
let them get back to me.”
Besides the bathhouses, Harris and other trained outreach workers from ACCESS go
to identified parks and bars handing out information and condoms.
“We tell them we’re not here to judge you; we’re not here to tell you what you
are doing is wrong, we’re here to give you some information.” “But we have to
get past the barrier of them being uncomfortable with us.” They are starting to
see that these outreach workers are not there to judge them, said Harris. They
have “goodie bags” to hand out with condoms, lube and all of the information on
syphilis and HIV.
Peterson sees the problem of MSM not being receptive to prevention messengers as
a problem with the message. “We continue to talk about male to male sex in a
disease context; that’s the only way we talk about it. We’re starting to see at
bathhouses, bookstores, etc - that to be a good interventionist you can’t go out
there with this disease model on your mind, because that’s what is going to come
out in your conversation,” he said.
“When Tony said people don’t talk to us because we are too in their face, that’s
exactly what that is; it’s that disease model. But for us to say, ‘you can get
your freak on and still not worry about getting something that you don’t want,’
that’s a more client-centered and individual-centered method of doing it. And
it’s not disease-based. It’s more wellness or health-based.”
Peterson would like to be able to convey to men, “You do not have to suffer
something negative as far as your health, just because you are who you are, if
you protect yourself and your partners.”
MAPP, DHD and CHAG also collaborate for locations of the Detroit outreach vans.
Harris provides the syphilis testing for the CHAG outreach van, which also
provides needle-exchange as well as counseling, testing, and referral services.
Currently, the Herman Kiefer STD clinic treats 59% of syphilis cases. This
outreach project also coordinates with smaller clinics that could provide
syphilis testing, Adam Butzel and Northeast Community Clinic. Advantage Health
Care (formerly Detroit Health Care for the Homeless) also does syphilis testing.
Harris would like to see more CBOs involved in this MSM syphilis/HIV prevention
outreach. “I can see this working out very well – we are just understaffed.”
“It’s an underground population that you would be surprised at; the average
person just does not know what’s going on.”
For more information, contact Mark Peterson at MAPP 248.545.1435, ext.106.
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