Syphilis Rates Rise, Gay Men at Risk
By Randy Dotinga, HealthDay Reporter
THURSDAY, Nov. 20 (HealthDayNews) -- Syphilis rates continue to rise among gay men in the United States, dashing federal efforts to eradicate the disease and boosting fears that safer sex is on the wane.
"These findings suggest that unprotected sex may have increased among gay and bisexual men, particularly those living with HIV," says Dr. Ronald O. Valdiserri, deputy director of the sexually transmitted disease department at the Centers for Disease Control and Prevention. An estimated half of gay men diagnosed with syphilis are also HIV-positive.
The number of syphilis cases is still small -- just 6,862 were reported in 2002, according to figures on sexually transmitted diseases released Thursday by the CDC.
But that's 12.4 percent more than in 2001, and it's also an 85.2 percent increase among white males. The increase marks the second year in a row that syphilis cases in the United States have gone up after a decade of declines.
Syphilis is striking especially hard in four big cities -- Baltimore, Detroit, Newark and San Francisco. Their rates are as much as eight times higher than other cities like Philadelphia and Phoenix, officials say.
The new statistics are in this week's Morbidity and Mortality Weekly Report, which did contain some good news on one other sexually transmitted disease: Gonorrhea, which affects both heterosexuals and homosexuals and is still far more common than syphilis, is at its lowest level in four years -- 351,852 cases in 2002. The disease can be treated with antibiotics, although new strains have developed immunity to some drugs in recent years.
But, the report also says, chlamydia remains the most common sexually transmitted disease in the United States, with a whopping 834,555 reported cases and an estimated 2.2 million more undiagnosed cases. Based on tests of young women at family planning clinics, chlamydia is most common in Georgia, Louisiana, Mississippi, Texas and the Virgin Islands, the report says.
Other than AIDS, syphilis is perhaps the most dreaded sexually transmitted disease. It is spread through both homosexual and heterosexual sex.
Fortunately, the disease can be easily cured in its early stages by the old standby antibiotic penicillin, which has yet to lose its ability to wipe out the bacterium that causes syphilis.
If not treated, however, syphilis can cause heart problems, brain disorders, blindness and eventually death. Many famous people from history have suffered from syphilis, and some -- including gangster Al Capone -- died of it.
Syphilis was a major U.S. health problem in the middle of the last century and reached a high of 106,000 cases in 1947. Since then, the numbers have dropped -- except for an increase during the crack epidemic of the late 1980s and the current rise in cases.
In the late 1990s, health officials hoped they would be able to vanquish syphilis, largely by focusing on African-Americans, a high-risk group. But now, while black Americans remain at higher risk than other races, gay and bisexual men appear to be extremely vulnerable, according to federal health officials.
While the government doesn't collect statistics on the sexual orientation of syphilis patients, an estimated 40 percent of those infected in 2002 were gay or bisexual.
AIDS complicates matters. Scientists suspect that the presence of syphilis, which can cause genital sores and cankers, makes it easier to transmit the AIDS virus or get infected by it.
It's not entirely clear whether AIDS rates are on the rise, although some research suggests that they are. The problem is that it can take some time -- months or even years -- before people realize they're infected.
Syphilis can also hide unnoticed in the body from 10 to 90 days after infection, the CDC says.
Early symptoms can be minor, and blood tests for the disease are less common than they were 20 years ago, says Dr. David H. Martin, director of the Louisiana STD Research Center. "People have gotten used to the idea of relatively few syphilis cases."
For more on syphilis and other sexually transmitted diseases, visit the Centers for Disease Control and Prevention or the American Social Health Association.
SOURCES: Ronald O. Valdiserri, M.D., deputy director, HIV, STD and TB prevention center, Centers for Disease Control and Prevention, Atlanta; David H. Martin, M.D., director, Louisiana STD Research Center, and chief, infectious diseases division, Louisiana Health Sciences Center, New Orleans; Nov. 21, 2003, Morbidity and Mortality Weekly Report
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