San Francisco Has Nation’s Highest Rate of Syphilis

San Francisco has the nation's highest rate of syphilis cases, according to new CDC data. San Francisco's highest syphilis rate since 1999 -- 40.6 cases per 100,000 in 2002 -- was apparently driven by infections among gay and bisexual men. The city's rate compares to a national syphilis rate of 2.4 cases per 100,000 people in 2002, itself a 9.1 percent increase from 2.2 cases per 100,000 in 2001.

The city's increase in syphilis cases may be attributable in part to improved screening and outreach efforts, health officials said. The city, in conjunction with community groups, has opened three testing sites and Web page-initiated testing, and testing increased 33 percent from 1999 to 2002.

However, increased screening is not solely responsible for the rise. "We know that the increased number of cases is definitely related to increased transmission," said Dr. Jeffrey Klausner, San Francisco's director of STD control. "People are coming in with lesions; people have sores, and there is an increased number of syphilis cases of the brain. That's real disease and real transmission," Klausner said.

California's syphilis cases almost doubled from 2001 to 2002, rising to 1,046, according to state health officials. Preliminary 2003 estimates indicate the infection rate is slowing.

While releasing the CDC data, officials cited a New York study comparing the behavior of gay and bisexual men with syphilis and without syphilis. Men with syphilis were more likely to report engaging in unprotected anal intercourse, attending private sex parties to meet partners, and using methamphetamine and Viagra or other drugs before having sex. They were also more likely to have HIV. According to Lee Klosinski of AIDS Project Los Angeles, "Most people are finding sex partners on the Internet, and the Internet has emerged as a more problematic area in terms of syphilis transmission."

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