Hawaii: Rise in STDs Worries Officials

An increase in syphilis and gonorrhea in Hawaii has public health officials worried about a possible resurgence in HIV. The trend mirrors what is happening in several U.S. cities where STDs are spreading, particularly among gay men. The number of Hawaii's syphilis and gonorrhea cases is the highest in at least ten years, with a dramatic increase during the last two years.

The state Health Department reports there were 484 new cases of gonorrhea reported in 2000, 603 in 2001 and 744 in 2002. The cases are almost evenly split between men and women. The pace has increased in 2003, with 252 gonorrhea cases reported from January through March. Syphilis cases rose from 14 in 2000 to 38 in 2001 and 64 in 2002, and they overwhelmingly involve men. Complete statistics for 2003 were not available.

What is different about most of the recent cases of syphilis is that they were acquired by man-to-man sexual contact and originated within Hawaii, said Peter Whiticar, chief of the state Department of Health's STD/AIDS Prevention Branch. Previously, syphilis was typically spread by heterosexual relations and was contracted out of state, he said.

Jason Mossholder-Brom, an HIV prevention services director at Life Foundation, said many gay men may not be aware of the recent upswing in STDs. Life Foundation provides counseling, support, testing and outreach services. He said preventing STDs is not a matter of awareness, since the gay community has been "HIV-education saturated." "Young men struggled to modify their behavior to prevent HIV infection. This type of infection [syphilis] is easier to contract," Mossholder-Brom said. "Now we're asking young men to not only use a condom every time but to be extra cautious about their behaviors." In other words, "what you're doing may not be enough."

Hawaii's chlamydia cases have also increased, from 2,604 five years ago to 4,530 last year, according to the Health Department. Of 1,306 cases in the first quarter of 2003, 988 involved women.

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