Audio New program aims to reduce STDs among black men in Minneapolis (story audio) Photos James Peters Romeo Smith Patricia Harrison View full slideshow (5 images) Resources Minneapolis Department of Health and Family Support Fremont Clinic Your Voice Join the conversation with other MPR listeners in the News Forum.

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New program aims to reduce STDs among black men in Minneapolis
by Julie Siple, Minnesota Public Radio
May 12, 2004

James Peters is a youth advocate at Fremont Clinic. (MPR Photo/Julie Siple)

New numbers from the Minnesota Department of Health show sexually transmitted diseases are on the rise in Minnesota. Since 2002, new diagnoses of chlamydia have risen 5 percent, and gonorrhea is up 6 percent. Most of the increase is among people between 15 and 24 years old. In Minneapolis, rates are particularly high among young African-American men. Now, with the help of a federal grant, health officials are trying to lessen the disparity by connecting with young black men who are among the hardest to reach.

Minneapolis, Minn. — Romeo Smith and James Peters aren't your typical health care workers. They wear trendy sneakers, listen to hip-hop, and spend most of their day in high school. After classes, however, they drive around north Minneapolis -- talking to strangers about gonorrhea and chlamydia.

James and Romeo are youth advocates for Fremont Clinic on the north side. The clinic pays them to talk to young men on the street about abstinence and safe sex. The goal is to convince young men that if they're sexually active, they should get tested for sexually transmitted diseases.

	Romeo Smith

James admits that he approaches people a bit differently than most doctors would.

"We ain't gonna come to them speaking all proper or strong-toned or anything like that," James says. "We're gonna speak ebonics like they speak. We're gonna come to them, 'What up, what up?'... Instead of us coming to them like we're some Jehovah's Witnesses or something, like we're all quiet. Like, 'Hey, hello, we're just here to do this, and do that.' They're just looking at us like, they're boring."

On a spring afternoon, James and Romeo are looking for spots where teenagers hang out. They pull into a parking lot on the north side.

"We're going to Snow Foods," says James. "It's right next door to the police station. And it's a big spot where teens like to stay at, because the police really don't focus on it since it's right next door to the police station."

About eight guys are hanging out near the store. Some of them seem to recognize James and Romeo, who walk up and offer packets of condoms, along with information about STD symptoms and treatment. They're interrupted when a police officer pulls into the lot, and everyone but James and Romeo scatters.

	Patricia Harrison

Back in the car, Romeo is pleased because he's convinced one person who may have an STD to get tested.

"I was talking to a friend, and I got him engaged," Romeo says. "I told him about the clinic, and he started saying, 'Oh yeah, I'm gonna come in. Do we have to set up an appointment?' I'm like, 'No, there's no appointment. Everything is confidential. You come in, and they take care of you from there.' And he told me he's gonna check it out."

Since Fremont started sending youth advocates out into north Minneapolis about two years ago, the clinic has seen a significant increase in young black men coming in for health care.

City health officials noticed that increase and applied for a federal grant to expand the program. They're using the five-year, $1.3 million award to start a similar project on the south side of Minneapolis, hire more people to work the street on the north side, and give James and Romeo a new tool. Now the youth advocates have an STD test they can offer right on the street.

"All it takes is peeing in a cup, if I may be so blunt," says Sandra Levine, assistant director at Fremont Community Health Services.

	Marlon Moore

According to Levine, new technology allows STD tests on samples collected in the field. Basically, that means a guy can walk around the corner, produce a urine sample, hand it over to James and Romeo, and find out five days later whether he has an STD.

Minneapolis health officials say it's worth the extra work, because the program is connecting with people who aren't being reached through school, work, or religious groups -- and who often avoid going to the doctor. They may not have health insurance. They may not have transportation. Also, according to Marlon Moore, who oversees the youth advocates at Fremont Clinic, they may not trust health providers, who are often white.

"They're not looking across the room at a person who looks like them," says Moore. "They're usually looking at someone that looks totally different from them, who's over 45. 'He doesn't know anything about us, doesn't come from north Minneapolis at all.' That is one of the biggest barriers, just the whole idea that we're not the same."

That, Moore says, is why health officials have to send people into the community who know what it's like to be young, black, and male in Minneapolis. He believes the youth advocates, who grew up in the neighborhood, can get people to trust them.

That trust is going to be especially important when they're asking for urine samples. Patricia Harrison is research director for the Minneapolis Department of Health and Family Support, which is administering the project. She says the youth advocates are going to have to convince people that the samples won't be used for other purposes.

	Getting ready

"One of the first things young men in this community ask about with the urine test is whether it can be used to detect drugs," Harrison says. "They know how the criminal justice system works. They may be on probation themselves. This is not the first thought that medical professionals would normally have about a urine test. But it is about a young black man in a community, who may know somebody else who got thrown back in jail because they failed a drug test."

Because the technology is new, not much is known about whether on-the-street tests can actually reduce STD rates among hard-to-reach populations. Even if they get more people tested, the youth advocates will have to convince people to go in for treatment. Moore believes that if the tests are positive, the hardest work will already be done.

"Once you got them in that test mode, and they do a test, they want to know," Moore says. "So getting them back is not going to be a problem."

If the program works, health officials hope they'll do more than prevent and treat chlamydia and gonorrhea. They want to lower teen pregnancy rates, and they want more young black men in these neighborhoods to start going in for preventative care.

What's more, they want people like James and Romeo to get good job experience, and maybe even consider a career in health care. James likes that idea, even though it's not an easy job, and not everyone understands what he does.

"The adults... if I told them I worked at the clinic or something, they'd probably be like, 'What you do, you a janitor, you clean up there?'" says James. "'No, I just get people tested.' I was talking to someone yesterday, they were just like, 'You a janitor there? You a janitor?' I'm like, 'No, I ain't no janitor now.' The teens... they take it real serious that there's something serious out here that they should be worried about."

Minneapolis health officials will be watching the numbers to see how the project works, if it's cost effective, and whether it might be replicated elsewhere in the country.

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