CDC Links Rise in New York City Syphilis Cases to HIV, ‘Risky’ Sexual Behavior Among Men Who Have Sex With Men
The number of syphilis cases has "increased dramatically" among men who have sex with men in New York City, leading officials to worry that a "resurgence in risky sexual activity" has occurred, according to a CDC report published in today's Morbidity and Mortality Weekly Report, the Washington Post reports (Haughney, Washington Post, 9/27). Based on statistics reported by health care providers to the New York City Department of Health and Mental Hygiene, the report found that after "declining steadily" for 10 years, the number of syphilis cases doubled from 117 in 2000 to 282 in 2001 (de Luise et al., "Primary and Secondary Syphilis Among Men Who Have Sex With Men -- New York City, 2001," MMWR, 9/27). In 1990, 4,265 syphilis cases were reported in the city (Worth, New York Times, 9/27). Of the cases reported in 2001, 263, or 93%, occurred among men. Of the 188 men who provided information on their sexual history, 79% were men who have sex with men. Among those men, 86 were aware of their HIV status: 48% were HIV-positive in 2001, compared with 49% in 2000 and 20% in 1999 ("Primary and Secondary Syphilis Among Men Who Have Sex With Men -- New York City, 2001," MMWR, 9/27). The number of syphilis cases dropped among black men but rose among white men (Washington Post, 9/27).
Sign of Unsafe Behavior
The CDC said that the increase in syphilis cases suggests that men may not be practicing safe sex because "life-extending" HIV treatments are available. "Increased sexual risk-taking might also be related to 'AIDS burnout,' which is associated with years of exposure to prevention messages and long-term efforts to maintain safer sex practices," the CDC reported (Niesse, AP/Fort Lauderdale Sun-Sentinel, 9/26). Officials also said the increase may be linked to "misperceptions of risk and the impact of other health problems such as depression and substance abuse" (Reuters Health, 9/26). New York City Health Commissioner Thomas Frieden said, "We have a different generation of young gay men -- a generation that didn't grow up with all their friends dying of AIDS" (AP/Fort Lauderdale Sun-Sentinel, 9/26). Ronald Johnson, associate executive director for Gay Men's Health Crisis, said the increase in the number of syphilis cases is "one of the first flags and indicators ... that there are increases in the levels of unprotected sex" (Washington Post, 9/27). The study said that public health officials, along with the gay community, should "develop and implement new, effective prevention approaches" to cut the risk of HIV and STD transmission among men who have sex with men ("Primary and Secondary Syphilis Among Men Who Have Sex With Men -- New York City, 2001," MMWR, 9/27). The Washington Post reports that syphilis outbreaks have recently occurred in Seattle, Chicago, Miami, Los Angeles and San Francisco. In San Francisco, the number of syphilis cases has increased four-fold in the past three years (Washington Post, 9/27).