California: San Francisco Saw "Dramatic" Syphilis Rise in '08

Syphilis is on the rise in San Francisco, with preliminary data showing a 66 percent increase in primary and secondary cases last year. In 2008, there were 339 primary and secondary syphilis cases, compared to 204 cases in 2007. Total early syphilis cases increased 55 percent, from 472 cases in 2007 to 658 cases in 2008. In the city's Jan. 27 STD report, health officials called the increase "dramatic."

"I think it is a real concern," said Dr. Ken Katz, an epidemic intelligence service officer with the CDC who is assigned to San Francisco. "Syphilis can make people sick, can make people more likely to acquire and transmit HIV infections, and can have lots of serious health outcomes."

The number of syphilis cases among HIV-positive men has remained level, representing 66 percent of cases in 2008. Health officials attribute this trend to "serosorting," or HIV-positive men having sex with other HIV-positive men and therefore not using condoms.

Dr. Jeffrey Klausner, director of the city health department's STD control branch, said "severe cuts in federal funding" have hampered syphilis reduction efforts. He advocates educating "people who take care of people with HIV infections about the need to test patients who are sexually active gay men every time they get a blood test," said Klausner.

"If sexually active gay men get tested every three months, detections can be found early and we can control this epidemic," Klausner said.

San Francisco plans to revive the "Healthy Penis" campaign, which was halted in 2006. The successful social marketing initiative used cartoon penis and syphilis sore characters to encourage STD testing. "We know Healthy Penis works," Klausner said. "It has been evaluated by researchers around the country."

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