Bay Area Reporter - July 26, 2007
Seth Hemmelgarn

That's the kind of reaction San Francisco's public health department is hoping for as it launches its "Dogs are Talking" campaign designed to educate people about syphilis.

Relying on men's attachment to dogs, the campaign will feature posters and ads with pictures of cute dogs and slogans such as "So many crotches, so little time." The campaign will primarily be focused in the Castro and South of Market, encouraging regular testing.

The campaign will target gay and bisexual men between 35 and 45. This group has the highest rates of new syphilis and HIV infections of any 10-year age bracket, said Dr. Jeffrey Klausner, director of STD prevention and control services for the San Francisco Department of Public Health.

In 1998, there were eight new cases of syphilis among gay and bisexual men, he said. In 2006, there were 421 new cases, and so far this year there have been 185. Last year's total is a drop from the peak of 551 in 2004, but "that's still too high," he said.

Klausner said almost two out of three new syphilis cases are in HIV-positive people. He said syphilis can increase a person's viral loads and lower their CD4 cell counts. Although syphilis is curable, Klausner said it can damage the brain, bones, heart, and nervous system if it's not treated.

Klausner said people who are tested for STDs should not assume they're also being tested for syphilis, so it's important to check with the doctor. Sexually active gay or bisexual men should be tested every three to six months, he said. People who are HIV-positive should be tested when their doctors check viral load counts.

Free testing is offered at San Francisco City Clinic (www.sfcityclinic.org) and Magnet (www.magnetsf.org). Testing information is also available at http://www.stdtest.org.

Along with testing, the campaign will address methamphetamine and Viagra use, and meeting sex partners online, Klausner said. People who engage in those activities are likely to have more partners, he said, increasing their chances of getting an STD.

Klausner has long been a critic of Viagra and maintains that he has seen an association, though not necessarily a causation, between the use of crystal meth, Viagra, and increased rates of STDs. As previously reported, he tried unsuccessfully to get the Food and Drug Administration to rein in advertising for erectile dysfunction drugs such as Viagra.

A conference last fall on ED drugs that was supported by the National Institutes of Health, found little evidence to back up Klausner's position.

However, the point of the new campaign is not to say, "Don't have sex." Mikael Wagner, president of Promotions West, the public relations firm that created the campaign, said focus group participants said they wanted "sex-positive" messages, and Klausner calls sex a "good, natural, normal healthy activity." However, he said, it's important to continue to educate people about risks.

This year's campaign follows the "Buck Syphilis" and "Healthy Penis" campaigns. Jacqueline McCright, the health department's community-based STD services manager, said those campaigns educated many people who didn't realize syphilis is still around. But "it's essential we continue to raise awareness, because the population changes," McCright said.

The cost of the campaign is $66,000, which Klausner called "very inexpensive." The cost includes planning, focus groups, surveys, educational materials, and advertising, including in the Bay Area Reporter. He said the department is skipping expensive spaces such as billboards, which he said can cost $15,000 a month in the Castro. This time, the department is using less-expensive means, such as palm cards, peer-to-peer outreach, and social networks, which Klausner calls "much more effective."

Finding less expensive ways to operate will be even more important next year. Due to cuts from the federal government, the department's syphilis budget next year will be almost half of what it is this year, Klausner said. He predicts disease rates will go up as a result. "It's completely misguided," he said.

For more information, visit www.dogsaretalking.com.

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