Field Placement: Los Angeles County Health Department, Sexually Transmitted Disease Program -- Community Outreach Services Unit
Location: Los Angeles, CA
Preceptor: Elaine Waldman, The Community Outreach Services Unit (COSU) Project Director
Student Name: Jennifer Toller
Year: 2003

For twelve weeks in the summer of 2003, I completed fieldwork at the County of Los Angeles Department of Health Services, Sexually Transmitted Disease Program, Community Outreach Services Unit. The Community Outreach Services Unit (COSU) Project Director, Elaine Waldman, supervised my fieldwork project, “STD Education and Outreach in Downtown Los Angeles.” From June 23, 2003 through September 12, 2003, I worked with the Unit to develop, to implement, and to begin to evaluate a program of education, testing, and outreach among immigrant Latina vendors in the Garment District.

The primary focus of my internship was chlamydia prevention. In 2002, COSU received a grant from the Centers for Disease Control and Prevention for a chlamydia prevention project called the Downtown Chlamydia Mobilization Project. The CDC and the STD Program are interested in chlamydia because it is a preventable and treatable sexually transmitted disease that can have serious long-term effects on reproductive health if left untreated. Chlamydia has been the most frequently reported STD in Los Angeles County since 1997, and rates of the disease per 100,000 Los Angeles residents have increased 38 percent in the last 5 years [1]. This increase has not been distributed equally among all population groups; chlamydia disproportionately affects young women of color. Among Latinas in LA County, there were 659 reported cases of chlamydia per 100,000 population, over 5 times the rates for non-Latino White females [1]. The statistics may not even tap into the extent of the epidemic among Latinas, however. Due to lack of knowledge about health services and fear of authorities discovering their undocumented immigrant status, experts believe chlamydia is underreported among immigrant Latinas in Los Angeles [1,2].

The goal of the Downtown Chlamydia Mobilization Project (DCMP) is to improve the primary and secondary prevention of chlamydia among immigrant Latinas working as vendors in the Garment District. During the formative research stage of the project, it became apparent that these women were not likely to change their sexual behaviors (such as condom use) while other basic needs (such as receiving minimum wage and having a safe work environment) were not being met. DCMP therefore has a goal of incorporating worker rights and worker safety and health with its sexual health message. DCMP involves a wide range of activities, including coalition building and networking with existing health and social service agencies; street-based social marketing of condoms; development of appropriate health education materials; individual and group health education in multiple settings; testing blood and urine for STDs; and referring clients to clinics for treatment.

As part of the internship, I participated in each part of DCMP, and gained knowledge and skills in health education, especially among Latinas. I spent at least one day per week on the streets of the Garment District with my coworkers, pushing a brightly-colored office cart, giving out condoms and health information, and answering questions, focusing on our target population of vendors. Other specific activities in which I participated as part of the fieldwork experience include: attending trainings on STD education; educating women (in English and Spanish) in the Garment District about STDs and free reproductive health services, using an informal, street-education approach; performing patient intake and HIV, syphilis, gonorrhea, and chlamydia testing through the mobile outreach van; assisting in the development of a discreet way to bring urine-based chlamydia and gonorrhea testing to the vendors; participating in monthly coalition meetings for the Coalition for Occupational Safety and Health; and developing a laminated resource card (English and Spanish versions) with reproductive health resources listed on one side and worker rights / worker safety resources listed on the other.

Bibliography

1. County of Los Angeles Department of Health Services, Sexually Transmitted Disease Program. Sexually Transmitted Disease Morbidity Report 2000-2001. Los Angeles, CA: County of Los Angeles Department of Health Services, 2002.

2. Jorge Montoya, Ph.D., research scientist with the County of Los Angeles Department of Health Services, Sexually Transmitted Disease Program. Presentation at the June 30, 2003 meeting of the Downtown Chlamydia Mobilization Project Meeting.

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