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Syphilis and HIV: A Dangerous Duo Affecting Gay and Bisexual Men

December 14, 2012

A blog by Gail Bolan, M.D., Director of the Division of STD Prevention, Centers for Disease Control and Prevention (CDC), discusses surveillance data released in CDC's 2011 STD Surveillance Report. Bolan draws attention to the increase in primary and secondary syphilis rates among gay and bisexual men -- who account for more than 70 percent of all infections -- and what can be done to reverse the high rates of infection among this sector of society. She notes that a large number of these infections are among young men who have sex with men (MSM), with the highest rates among 20-29 year olds.

Annual surveillance data in the report emphasize the disproportionate burden of disease among gay and bisexual men. Bolan explains that the genital sores caused by syphilis make sexual transmission and acquisition of HIV even easier. Hence, there is an estimated two-to-fivefold increased risk of HIV if persons with syphilis are exposed to the virus. Also, studies show that syphilis increases the viral load of persons with HIV infection. These facts increase Bolan's concern, since data show that four of every 10 MSM with syphilis is co-infected with HIV. Bolan argues that the stakes are too high to ignore these health disparities and emphasizes the importance of promptly diagnosing and treating syphilis infections among MSM to decrease their chances for HIV infection.

Bolan stated that to fight the root causes of health disparities among gay and bisexual men involves confronting the underlying conditions that place the group at greater risk of STDs. She contends that risk behavior alone does not explain the disproportionate STD burden of MSM, but that complex issues such as homophobia and stigma are responsible to some extent for these infections. She discusses how CDC is working with program partners to take action to confront the underlying causes of STD disparities and provides the example of the more comprehensive holistic sexual healthcare through CDC's program collaboration and service integration. Also, action plans guided by the best available science and input from partners are being implemented to help individuals and communities overcome environmental forces that increase the risk of acquiring an STD.

Bolan is aware that government cannot do it alone and that more broad-based action is needed by all involved. She envisages that working together, government and individuals can face sexual health issues. The blog concludes with Bolan' suggestions for what health care providers, individuals, and community leaders should do to create greater awareness and openness about sexual health issues, to help end the disparity, and to ensure good health for gay and bisexual men who are disproportionately impacted by STDs and HIV.

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Excerpted from:
12.13.2012; Gail Bolan

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