Progress on Syphilis in Most of Country; Cases Hit New Low in US, but Triple in San Francisco

Syphilis cases in the United States have fallen to a new low, but the CDC warned yesterday that this progress was threatened by several pockets of rising infection, including San Francisco and other cities with large gay populations. Health authorities in San Francisco, Los Angeles and Seattle, among other big cities, have recently been reporting a sharp increase in syphilis and other STDs, which could signal a resurgence in HIV after years of improved statistics.

Dr. Jeffrey Klausner, director of STD prevention for the San Francisco Department of Public Health, said the city had seen 158 cases of early syphilis so far this year -- more than triple the total for all of 2000. About 28 percent of the 2001 cases were reported in the past five weeks alone. "We're still going in the wrong direction," Klausner said.

Nonetheless, this year's total is a tiny fraction of the cases seen a few years ago: Syphilis cases in San Francisco peaked at 2,300 in 1982. Some of the recent jump is tied to better screening and earlier detection, Klausner said. However, local surveys also show a genuine -- and to public health officials, disturbing -- increase in infections from more risky sexual activity in some populations, particularly men who have sex with men. Similar patterns are evident all around the country. The challenges facing health officials include burnout in gay communities long saturated by safe sex messages and the mistaken view that HIV and other STDs are no longer much of a danger since the advent of more effective drug therapies.

Jeff Getty of the San Francisco's Survive AIDS group called the increase in risky sexual activity and syphilis infections "a shameful thing" for the gay community. But he added that many fear the Bush administration is setting the stage for a "repressive backlash." Getty said, "I'm not very optimistic at all. Is the goal here going to be to get rid of syphilis or to stop gay men from having sex?"

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