Minnesota: Rise in Syphilis Sparks Fears of Rise in HIV

An outbreak of syphilis in the Minneapolis-St. Paul, Minn., gay community is sparking fears that it will soon be followed by an increase in HIV and other STDs, state health officials said last week. Similar outbreaks in Los Angeles, San Francisco and New York have been caused by an increase in unsafe sexual practices, officials said, and are viewed as a harbinger of higher HIV rates. The number of new cases in Minnesota has not grown substantially, doubling to 33 last year and 16 so far this year, according to the state Health Department. However, all but one of the new cases this year are among men; most of them are gay, and half have HIV.

The combination of HIV and syphilis can be particularly lethal, experts said. Early-stage syphilis, marked by skin lesions and rashes, increases the likelihood of HIV infection threefold, but the rashes and lesions can be hidden and are not painful.

The syphilis outbreak is particularly worrisome because state officials recently reported an unexpected increase in new HIV infections. After declining for five years, the number of infections in white men rose from 93 to 130 in 2001. Experts have said the increase was almost exclusively among gay and bisexual men.

In Los Angeles, 61 percent of its 187 cases last year were among gay or bisexual men, as were 82 percent of San Francisco's 139 cases. And more than half of the men who contracted syphilis were HIV-positive. In Minnesota, the 33 new cases last year were evenly divided among men and women, but 24 were among blacks, raising concern among health officials. So far this year, that trend has not continued: Five new cases have been reported among blacks, the data show.

Lorraine Teel, executive director of Minnesota AIDS Project, said she applauds state officials for taking steps to reach minority groups such as blacks and immigrants, but she said resources still are needed to reach gay men. "This is where the epidemic has been, is, and frankly, will be for some time," she said.

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