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Syphilis On The Rise

The syphilis rate has increased for the seventh consecutive year in 2007 in the US, with a significant increase in the number of infections in gay and bisexual men.

A new report from the Centers Disease Control and Prevention backs up previous statistics which show many men remain untested for STDs.

“STDs remain a major threat to the health of gay and bisexual men, in part because having an STD other than HIV can increase the risk of transmitting or acquiring HIV,” said Kevin Fenton, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

“The resurgence of syphilis among MSM [men who have sex with men] represents a formidable challenge to our STD prevention efforts, but one that is surmountable. The solution comes down to making STD screening and treatment a central part of medical care for gay and bisexual men, while finding innovative ways to help MSM avoid STD infections – including HIV – in the first place.”

The preliminary 2007 syphilis data show that the US national rate of primary and secondary syphilis – the most infectious stages of the disease – increased 12% between 2006 and 2007, from 3.3 to 3.7 cases per 100,000 population.

As in recent years, this overall increase was driven by continued increases among males, from 5.7 per 100,000 in 2006 to 6.4 per 100,000 in 2007.

Several sources of data indicate that substantial increases in syphilis among MSM since 2000 largely account for the overall trend in males.

The rate among females also increased between 2006 and 2007, from 1.0 to 1.1 cases per 100,000 population. While the reasons for the third consecutive annual increase among females are still being examined, this emerging trend deepens concerns about a potential resurgence of syphilis among women, after more than a decade of declining rates.

Rates among African-Americans also remain much higher than rates among whites – six times higher for African-American men and 13 times higher for African-American women. Reported syphilis rates among African-American men increased 25 percent from 2006 and 2007.

The rate among African-American women rose 12 percent from 2006 and 2007.

Since 2002, CDC has recommended that sexually active MSM be tested at least annually for syphilis, chlamydia and gonorrhea – at all anatomic sites of reported STD exposure - oral, anal or urethral. CDC also recommends at least annual STD testing for all individuals with HIV infection.

However, three new studies indicate the urgent need to continue increasing STD screening rates among MSM.

The first, an eight-city STD clinic study found that as many as one-third of gonorrhoea infections among MSM who were not HIV-infected were missed because MSM were not tested at all relevant anatomical sites.

“While STD screening is by no means the only weapon in our STD prevention arsenal, it is certainly one of our best tools for ensuring prompt diagnosis and treatment and slowing the transmission of these diseases,” said John M Douglas Jr, director of CDC’s Division of STD Prevention.

Author: Joanne Oatts

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