Syphilis Rise in Gay, Bisexual Men Causes Worry
May 7, 2007
After dropping in 2000 to the lowest level ever recorded, the rate of syphilis has spiked -- especially among gay men, CDC said Friday. The U.S. syphilis rate rose for five consecutive years through 2005, the most recent year for which CDC had figures. Men who have sex with men (MSM) accounted for 7 percent of syphilis cases in 2000 but more than 60 percent in 2005, CDC estimates showed.
"We're concerned that we're seeing this upturn among [MSM] because it could foreshadow bigger increases," said CDC epidemiologist Dr. Hillard Weinstock.
Experts are particularly worried the syphilis spike among MSM could place them at higher risk for HIV/AIDS. "The most devastating consequence of this increase in syphilis cases would be an increase in the rates of HIV infection," said Dr. Khalil Ghanem of Johns Hopkins University School of Medicine. "Syphilis and HIV have a close, deadly symbiotic relationship."
Syphilis can raise the risk of HIV infection or transmission by an estimated two to five times, said CDC epidemiologist Dr. James Heffelfinger.
Joel Ginsberg, executive director of the San Francisco-based Gay and Lesbian Medical Association, said he is seeing the increase concentrated among a very specific subset of MSM: "those who are having a great deal of sex with multiple sex partners." Many are HIV-positive or learn they are infected with HIV when diagnosed with syphilis.
"Among these men, there seems to be decreased condom use, perhaps related to an attitude of 'I already have HIV, so why bother?' or because HIV is seen as a chronic disease that can be managed well with medications," Ginsberg said.
Use of the drug crystal meth has been associated with unsafe sexual practices linked to syphilis, said Ghanem.
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