Selective Screening to Augment Syphilis Case-Finding—Dallas, 1991

INCREASED USE of crack cocaine and the exchange of sex for drugs have been major contributors to the increased occurrence of syphilis in U. S. urban, minority populations.^1-3 Because many persons who use drugs do not voluntarily seek health care,^1-4 and because their sex partners are often difficult to locate,⁵ a substantial number of persons may have undiagnosed syphilis infections, thereby contributing to continuing transmission. Because of the continuing increase in the number of persons in Dallas County (1990 population: 1.8 million), Texas, in whom early syphilis^* had been diagnosed, and who had reported having sex partners at crack motels and crack houses (i.e., places where crack cocaine was sold), in February 1991, the Dallas Countywide Health Department (DCHD) developed a sexually transmitted disease (STD) screening program aimed specifically at those sites. This report describes Dallas County's selective screening program and summarizes results of the program from