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

1. “The Clap Doctor”, “The Father of Spin,” and Other Historical Lessons for Syphilis Elimination Bill Petz North Carolina HIV/STD Prevention and Care Branch

2. Treponema “What Will My Future Be Like?”

3. “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”

4. 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”

5. 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, …….

6. 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

7. 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

8. History Already Made

9. Edward Bernays1891-1995 “Father of Public Relations” • Nephew of Freud • Selling of WW I & II • Women’s smoking • Fluoridation of water • “engineering of consent”

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. Social marketing Media advocacy Mobile units Jail and prison screening Public opinion leaders Faith based initiatives Community advocacy New and Innovative

19. 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

20. Treponema “What Will My Future Be Like?”

21. Bill Petz • 828 669 3350 • Bill.Petz@ncmail.net • Menshealthnc@mail.com