Syphilis Epidemic Getting Much Worse in San Francisco

San Francisco's syphilis epidemic is continuing to spread, with the city expecting to report 750 new cases by the end of the year, up 50 percent from 2002, the city's public health department announced Thursday. Most of the cases occur among gay and bisexual men who have had unprotected sex with multiple male and female partners, officials said.

About two-thirds of the new cases affect HIV-positive people, which is alarming because it suggests people are having unprotected sex despite knowing their serostatus. Both HIV/AIDS and syphilis are sexually transmitted, but only syphilis is curable.

"Many people have lost their awareness or appreciation of syphilis as a health problem," said Dr. Jeffrey Klausner, who directs the health department's STD unit, which reported 494 new syphilis cases last year. Klausner noted that too many infected people do not even tell their doctors about their sexual practices and therefore do not get tested for HIV or syphilis. Because of social stigma that discourages people from even asking their physicians for such tests, many allow their own health to suffer and the diseases to spread.

In response, San Francisco's health department and AIDS prevention groups are renewing efforts to build syphilis awareness. Plans include making syphilis testing easier and more accessible and educating gay people and health care providers about the need for the tests. San Francisco has sought to overcome stigma with an online syphilis testing program that lets city residents sign up on the Web, have their blood drawn anonymously at various clinics, and learn their results on the site using a confidential identification number. For department information, visit www.dph.sf.ca.us. For online syphilis testing, visit www.stdtest.org.

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