From first looks, Sybrina Bernabei's office seems like a cluttered candy store, jar upon jar upon jar of items resembling gum and lollipops. Upon closer inspection (i.e., reading the labels), it's clear that the rainbow-colored packages have a serious purpose: ID is a "sensual lubricant" that is "water-based," "water soluble" and "rigorously tested for safety"; Trustex, the item wrapped in green with the leaf graphics, is a "mint- flavored lubricated condom." As outreach coordinator for Aid for AIDS of Nevada (AFAN), the city's oldest HIV/AIDS outreach group, Bernabei isn't so much a candy lady as she is an educator, dispensing knowledge—along with condoms and lubricants—in an attempt to win the battle against sexually transmitted diseases. It's a battle that, on at least one front, we're losing: "We're seeing a huge increase in syphilis because of meth use," she says.
According to the Clark County Health District, reported cases of early syphilis (which is transferable; it becomes latent if untreated) have nearly tripled, from 29 in 2003 to 50 last year to 86 cases already this year, through July, assuring that this will be the worst year yet. Unnerved by last year's spike, Rick Reich, communicable disease/AIDS services supervisor for the health district, says health officials recruited a three-member team from the federal Centers for Disease Prevention and Control in Atlanta to study the problem.
"They came out a few months ago and confirmed the outbreak," Reich says. "Before, with this disease, the outbreak was primarily among heroin addicts. But now we're seeing methamphetamine play a bigger role. Meth reduces inhibitions so people engage in more risky behaviors and don't take the necessary precautions. We are nervous about the increase."
The rash of new syphilis contractions has put the health district into what Reich calls "outbreak prevention mode"—think a disease-control version of the nation's color-coded security system. More specialists are investigating the problem and more personnel are being cross-trained—staffers who specialize in HIV/AIDS education are learning tools used by folks who deal with sexually transmitted diseases (STDs), and vice versa. "It's all about interviewing people, getting them treated and contacting folks who might have been exposed," Reich says.
But the Internet complicates the last part of the equation—contacting possible carriers. Freed from their inhibitions, health officials say meth users are more likely to tool around chat rooms and message boards, setting up rendezvous and then having unprotected sex with strangers. Chris Reynolds, who works in the health district's Office of AIDS and travels cyberspace trying to educate the people behind the screen names, says some people know so little about who they're sleeping with that it's nearly impossible to contact partners who may have been exposed to syphilis or other STDs.
"People may only remember a screen name," Reynolds says. "And it's difficult signing up on a website and announcing that you're a health official. The people who operate the websites often don't want you on there."
While the meth-syphilis connection may be a relatively new issue locally, it's been gaining traction nationally in recent years. According to a March 2004 Miami Herald article, government health experts presented findings during that year's National STD Prevention Conference in Philadelphia linking crystal meth use with spikes in STDs, including HIV and syphilis, among gay and bisexual men. In response, cities like New York and regions like South Florida formed coalitions to address the problem.
In Las Vegas, as in much of the country, meth's overall impact has been pernicious (Newsweek devoted the cover story of its August 8 issue to the nationwide scourge). Aside from being linked to the current syphilis outbreak, meth has been blamed for: a 30 percent spike, from 2003 to 2004, in the number of Clark County children removed from their families due to child abuse or neglect; and exacerbating the local mental health crisis—many of the mentally ill patients crowding hospital emergency rooms are meth users. Fighting meth's scourge keeps law enforcement busy; local and federal agencies annually bust 1,000 labs. And no place in town is immune: Labs have been found in the tony Lakes neighborhood, in trunks of cars, mobile homes, motels, out in the desert. Last July, the Metropolitan Police Department's Fiscal Affairs Committee approved a $57,000 federal grant for Metro's Street Narcotics Meth Suppression Program, which infiltrates suspected meth labs. This is on top of nearly $200,000 in federal monies Nevada received in 2004 to fight narcotics, mainly meth.
In some ways, the plight to educate the masses about meth's destruction—cocaine and marijuana still receive the most press—is similar to that of syphilis' relative anonymity in the face of headline-grabbing HIV/AIDS.
"When HIV/AIDS came on the scene, syphilis, which we'd nearly eradicated decades ago, became a stepchild," Reich says. "There is a lack of education on what syphilis is. Syphilis is easily treatable if you get checked right away, while it's incubating."
Back at AFAN, Bernabei is gathering materials for street outreach. Since the syphilis outbreak is highest among gay and bisexual men (70 percent of new cases, according to the health district), as well as drug addicts, sex-industry workers and johns (the remaining 30 percent), she and other AFAN outreach coordinators are planning their weekly visits to prostitution-laden Fremont Street and to the Fruit Loop, an area around the intersection of Paradise Road and Naples Drive, near UNLV, that's home to gay businesses.
Says Bernabei: "We go where the risk is high."