CDC Reports STD Rates Up Among Gay Men
Men who have sex with men are in the highest risk group for several of the most serious sexually transmitted diseases, with reports of syphilis and gonorrhea increasing "dramatically" in recent years, according to studies presented at the National STD Prevention Conference in Milwaukee. The Washington Blade reports that researchers believe the increase of STDs is the result of an "increase in risky sexual practices by a growing number of gay men who believe that HIV is no longer a life-threatening illness." The biannual CDC report, Tracking the Hidden Epidemic: Trends in STDS in the United States, points to several "alarming indications that gonorrhea and syphilis are on the rise among men who have sex with men," including a 26-city study showing that these men account for 13% of all gonorrhea cases, up from only 6% in 1994. Ronald Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention, noted that the recent "increases in unsafe behavior [due to] a perception that HIV is not as serious as it once was" indicate the need to "strengthen our relationship with leadership in the gay community." Washington, D.C., and the Pacific Northwest are two areas with the highest STD rates among men who have sex with men, according to the CDC report: King County, Wash., which includes Seattle, reported 88 cases of syphilis from 1998-1999 compared with zero cases in 1996, with 85% of cases occurring in gay or bisexual men. Washington, D.C., has the sixth highest rate of gonorrhea in the United States, with 3,536 cases overall, and the 14th highest rate of syphilis, with 45 cases overall. Nationally, there were 6,657 cases of syphilis and 650,000 cases of gonorrhea in 1999. Syphilis is "extremely concentrated geographically" with more than 50% of the reported cases occurring in just 20 cities and counties throughout the United States.
Why It Matters
STD incidence rates are important for measuring the rate of HIV, because individuals infected with STDs are between two and five times as likely to contract or spread HIV. A Chicago survey of men attending the "International Mr. Leather Competition" revealed that 42.5% of men did not know that syphilis facilitates HIV transmission, and 52.3% were unaware that syphilis is increasing among gay men in some areas. Seventy-four percent of these men also did not know that a rash can be an early sign of syphilis. But targeted prevention campaigns may help slow the spread of the disease; Baltimore's syphilis infection rate was reduced by 50% following a targeted prevention campaign, dropping the city from the highest syphilis rate in the nation to the third highest.
Human papillomavirus is another common STD that some studies show to be particularly widespread in the gay community, and which bears another strong link to HIV. According to a San Francisco study of men who have sex with men, nearly all
HIV-positive men are infected with HPV, and 60% of HIV-negative men have HPV. chlamydia is also reported to double the risk of catching or spreading HIV, CDC epidemiologist Judith Wasserheit said (Roundy, Washington Blade, 12/8).