In an attempt to cope with a syphilis outbreak among gay and bisexual men, Chicago Department of Public Health workers utilize a mobile unit to persuade men to get tested for syphilis and HIV. "Sometimes we've had 10 people in the van trying to get tested," said Yvonne Cruz, field operations manager for the mobile unit. "The community actually really likes us coming out here."

"The huge concern that everyone has is... the possibility of seeing an increase in HIV transmission," said John Flynn, men's health promotion manager at Howard Brown Health Center. "Syphilis, among other STDs, can facilitate HIV transmission."

While the total number of syphilis cases in Chicago decreased from 292 in 2000 to 277 in 2001, the percentage of cases involving gay or bisexual men soared to 57 percent from 15 percent. Through June, 180 syphilis cases had been reported, and 61 percent of those were among MSM, according to the Health Department. Up to 70 percent of gay and bisexual men infected in recent outbreaks have tested positive for HIV, added the department. The CDC says the number of AIDS cases in Chicago has come down from a high of 1,950 in 1993 to 847 in 1999.

Flynn said the rise in syphilis rates does not necessarily mean there has been a change in the sexual behavior of Chicago's gay and bisexual population, but he is aware of the theory that men have dropped their guard since protease inhibitors began making it possible to live longer with AIDS. "We have heard that HIV infection is not that much of a concern because people are experiencing AIDS burnout," Flynn said. "It's very stressful for people to think about that on a daily basis."

The city's Health Department is continuing to educate those at risk through fliers and by appealing to the gay and mainstream press for more coverage.

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