If they had their own TV show, it might be called Law & Order: STI, though the work of this Los Angeles LGBT Center team of detectives never ends in arrests, just treatment.
The mission of the four-person team is to encourage those who may have been exposed to a sexually transmitted infection (STI) to get tested and treated so they're not at risk of passing the infection to others. They begin their work by talking to people who have tested positive for syphilis or HIV at one of the Center’s testing facilities, offering assistance contacting sexual partners.
“Our goal is to identify those who may have been exposed to an STI and encourage them to get tested,” says team leader Johnny Cross. “Even when someone is upset upon receiving our call, they usually end up saying thank you. These things are treatable. It’s really about educating, getting to the next person and trying to stop it from going further.”
When contacting a partner, the Community Embedded Disease Intervention Specialists (CEDIS) team members take great care to deliver the message delicately and confidentially. They will say that someone who tested positive for an STI allowed them to notify partners who may have been exposed.
“Sex is something that’s on everybody’s mind but very few people like to talk about how to be sexually healthy,” says team member Mario Peregrino. “I think if you’re able to make people feel comfortable, they’ll open up. It’s a lot about our manner and conveying that we’ve got no judgement.”
Approximately 25% of the people who meet with a team member will share names of previous sexual partners to contact. The other 75% will either want to do it themselves or can’t because they had anonymous partners or just don’t remember their partners.
People who learn they may have been exposed to an STI frequently want to know who put them at risk. The team won’t ever share that information but they do say the person cared enough to ask them to make the call.
“In the beginning, I got more negative reactions and hang-ups than I do now,” Cross says. “We let them know, really from the bottom of your hearts, that we’re doing this to protect them and others.”
During the conversation, they let the person know that STIs are treatable, they offer to schedule a testing appointment, and they try to reduce the stigma associated with sexually transmitted infections. If someone notified by the team does test positive, they will ask them about their own network of partners.
“There are people who keep track of their partners,” says team member Edwin Dones. “Some will have names and phone numbers, but not everyone does. Not everyone can recall who they had sex with even two months ago. It’s important to know when they had sex with someone to know if it falls within the time frame of possible exposure.”
Putting on the Detective Hat
If the infected person has had an anonymous encounter, CEDIS team members have to do some sleuthing.
“It gets tough—particularly for people who meet through apps like Grindr. It’s really difficult,” says Cross. “Whatever contact information or clues someone can give us, we’ll use. If they just remember the apartment they were at with the person and the person lives there, we’ll take that information and try and do a field visit.”
Cross stresses that any contact CEDIS member makes is completely confidential. They frequently look for clues to find people who may have been exposed to an STI, but in the process they never leave clues with others regarding who they are or what they’re doing.
Cross once tracked a twentysomething guy to the home of his aunt with whom he was living. The young man didn’t have a car, so after privately breaking the news to him, Cross gave the guy a ride to the Center’s clinic so he could get tested.
“We talked on our way from the house. This was his first time being exposed to an STI, so I had the opportunity to educate him, put his mind at ease, and help reduce some of the stigma associated with it,” Cross remembers. “You really feel accomplished when you pick someone up and bring them to a clinic.”
Sometimes the team is able to get an email address, which is helpful when it comes to finding contacts from hook-up sites like Manhunt and Adam4Adam. Those sites allow CEDIS team members to log-in and contact users, through the site, who may have been exposed.
But the use of those sites has been eclipsed by the use of Grindr, a mobile app whose users don’t have unique screen names, making it much more difficult to find contacts.
Syphilis Cases On the Rise
Syphilis cases have been steadily on the rise throughout the country, but particularly in California. It’s due, in part, to the fact that people aren’t getting tested enough and are unknowingly transmitting STIs.
More than 20% of the reported cases in Los Angeles county are from tests administered at a Center facility. Each day, CEDIS team members get an average of 2-4 cases assigned to them. “If one of us is out for the day then the other three are overloaded,” says Cross. “It used to be just me doing this job and now we are hoping to add a fifth person.”
Cross became an HIV counselor at the Center in 2003. He was chosen to launch the CEDIS program in 2007 and was initially its only member. Two more members were hired in 2013 and a fourth in 2015.
Since the work of the Center’s CEDIS team has been so effective, Cross was recently invited by the National Coalition of STD Directors to Capitol Hill to lobby Congress for more STD (Sexually Transmitted Disease) prevention funding.
It is recommended that sexually active people get tested every three months. The Center offers free HIV/STD testing at its McDonald/Wright Building and the Center-WeHo. Anyone who tests positive for HIV or any other STDs is able to receive immediate care and treatment.
If you test positive for an STI and want to notify sexual partners yourself, here are four tips on how to do it:
- Let the person know how surprised you were to find out that you had the STI, that you’re getting treatment, and that you wanted to make sure they were aware so they can get themselves checked out too. As difficult as it can be to make this call or send this message, most people will appreciate it.
- Be calm and direct. Talking about STIs openly and without shame is the best way to end the stigma.
- If you tested positive for syphilis, explain to those you’ve had sex with in the last three months that it’s best for them to begin treatment immediately, even if their test results are negative. Syphilis can take up to three months to be detected.
- It's good for people to give the Los Angeles LGBT Center’s number (323-993-7500) to their partners so they have a resource if they need one.