Big Spike in San Francisco Syphilis Cases; Gay, Bisexual Men Affected Most

Syphilis is spreading at "startling" rates in San Francisco, especially among the city's gay and bisexual men, according to Dr. Jeffrey Klausner, director of STD prevention for the city's Department of Public Health. Similar syphilis spikes have been detected in San Diego, Florida, Boston and Chicago, Klausner said. The data -- which show syphilis cases increasing among the city's gay and bisexual men from 10 in 1998, to 29 in 1999, to 47 in 2000, and to 93 through September 2001 -- will be presented Saturday in San Francisco at the meeting of the Infectious Diseases Society of America.

This year and last, 23 percent of San Francisco men with syphilis reported meeting their sex partners in sex clubs; 20 percent in adult bookstores; 19 percent on the Internet; and 18 percent in bathhouses outside the city. The new data will show that in the syphilis cases involving gay and bisexual men this year, the 93 men reported having 1,225 sexual partners. The men could identify only 8 percent of their partners by name, making it difficult, if not impossible, to notify partners to get a checkup and possible STD treatment, Klausner said.

Officials say an America Online (AOL) chat room for gay and bisexual men in San Francisco is partly to blame for the syphilis surge. Last year, 10 cases were associated with the site; this year so far, 16 cases have been traced to it. Klausner said efforts to get AOL to post syphilis warnings on the site have met with resistance. Instead, AOL has offered health officials free memberships so that counselors could enter the chat rooms and post prevention messages. But the health department has declined the offer, saying it would be an ineffective STD prevention tool. "This is the proverbial canary in the coal mine," Klausner said. "People are using the Internet for sex and transmitting syphilis."

AOL spokesperson Andrew Weinstein said the company had been working with the CDC to develop STD prevention messages for its online bulletin boards. He did not know when the postings would be ready, or whether they would specifically target gay chat rooms.

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