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Syphilis Rates
Climb for Second Straight Year (onlinedatingmagazine.com -
November 20, 2003) The syphilis rate in the United
States rose in 2002 for the second consecutive year,
following a decade-long decline that led to an all-time
low in 2000, according to new data released today by
the Centers for Disease Control and Prevention (CDC).
The increase was due in large part to increases in
reported syphilis cases among men, particularly gay
and bisexual men. At the same time, continued declines
in syphilis among African Americans and women point
to the success of STD prevention efforts in some areas
and populations, although African Americans remain
the population most affected by syphilis.
The data, published in the November 21 issue of CDC’s
Morbidity and Mortality Weekly Report (MMWR), include
cases of primary and secondary syphilis (referred to
as “syphilis cases” in this release). These
new syphilis cases represent the early, contagious
stage of syphilis infection.
Between 2001 and 2002, the overall rate of syphilis
increased 9.1 percent, from 2.2 cases to 2.4 cases
per 100,000 population – the highest rate since
1999. The total number of reported cases increased
12.4 percent, from 6,103 to 6,862 cases. However, since
some syphilis cases go undiagnosed, the actual number
of infections is likely higher.
The increases in reported syphilis cases in 2002 might
be due in part to expanded syphilis testing in some
areas. However, on a national level, there has been
no significant increase in latent syphilis, the later
stage of the disease, which would likely occur if increased
screening was a major factor nationally.
Syphilis cases among men increased 27.4 percent between
2001 and 2002 (from 4,134 to 5,267 cases). CDC does
not collect syphilis data by sexual orientation; however,
study authors estimate that more than 40 percent of
all syphilis cases reported in 2002 occurred among
gay and bisexual men, accounting for much of the reported
overall increase in the disease.
By race, the increase in syphilis cases among men
included an 85.2 percent increase among non-Hispanic
white men and a 35.6 percent increase among Latino
men. Syphilis cases among African-American men declined
slightly (2.6 percent), but African-American men continue
to have the highest rate among men – 13.5 cases
per 100,000 population, compared to 4.5 among Latino
and 2.2 among non-Hispanic white men.
In contrast, there was a 19.0 percent decline in syphilis
among women overall (from 1,967 to 1,594 cases). Cases
declined 21.7 percent among African American women
(from 1,527 to 1,195 cases).
The continued declines in syphilis among African Americans
(10.3 percent in 2002) and among women of all ethnic
groups are likely the result of ongoing syphilis education
and testing efforts in these populations, especially
in the South. Overall, the rate in that region has
declined in recent years, and fell by 8.8 percent between
2001 and 2002. However, the syphilis rate among African
Americans in 2002 was still 8.2 times higher than among
non-Hispanic whites, signaling the continuing need
for STD prevention in this population.
“The campaign against syphilis in the United
States is now being waged on two fronts,” said
Dr. Ronald O. Valdiserri, deputy director of CDC’s
HIV, STD and TB prevention center. “We’re
working on one front to sustain the progress made among
populations formerly hardest hit by syphilis, including
African Americans and women. On the second front, we
are combating new challenges among gay and bisexual
men.”
Recent research has highlighted increases in unprotected
sex among some groups of men who have sex with men
(MSM), as well as high rates of HIV co-infection among
men diagnosed with syphilis (averaging about 50 percent).
These findings, plus HIV surveillance data from a recent
CDC 25-state study showing a 17.7 percent increase
in HIV diagnoses among men who have sex with men between
1999 and 2002, have raised concerns about a resurgence
of HIV in this population.
“Prevention challenges for gay and bisexual
men may include a low level of concern about other
STDs, as well as the belief that treatment advances
mean HIV is no longer a deadly illness, resulting in
relaxed attitudes toward safer sex practices,” said
Dr. John Douglas, director of CDC’s STD prevention
programs.
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