Massachusetts Public Health Officials Fear Resurgence of Syphilis Could Foreshadow HIV ‘Explosion’
Massachusetts public health officials fear that a "dramati[c]" resurgence in the number of new syphilis cases in the state could lead to an "explosion" of new HIV infections, particularly among men who have sex with men, the Boston Globe reports. Syphilis cases declined throughout Massachusetts and the nation in the 1990s; however, the number of new syphilis cases in Massachusetts increased 87% from 2001 to 2002, and 52 cases have been reported in the first three months of this year, compared with 32 over the same period last year. In 2002, 197 new syphilis cases were reported in the state, with 113 of the infected individuals having contracted the disease through sex with other men, according to the Globe (Smith, Boston Globe, 4/21). In 2001, the number of new syphilis cases in the United States rose for the first time in 11 years, with large increases occurring among MSM. The increase is a setback for the CDC's goal of eliminating syphilis in 90% of U.S. counties by 2005, but it also signals that many MSM are no longer practicing safe sex, which could lead to an increase in HIV and other sexually transmitted diseases (Kaiser Daily HIV/AIDS Report, 3/10).
Transmission of syphilis among MSM is a "profound reversal" from the early 1990s, when syphilis was found primarily in the heterosexual community and MSM represented less than 1% of all syphilis infections. The reasons for the resurgence are "complex" and include the "erosion" of STD prevention campaigns and the reemergence of "risky sexual behavior," according to the Globe. "Once an infection is well-established in a particular population, it can spread very easily and quickly," John Auerbach, executive director of the Boston Public Health Commission, said, adding, "The challenge is always to mobilize when the numbers are small enough so that a disease does not become firmly established." A "broad-based" syphilis education campaign directed at MSM will begin in May in Massachusetts, and a health advisory -- which is part of the campaign -- has already been issued to physicians alerting them to the outbreak and urging them to provide counseling to patients who might be at risk of contracting syphilis. As part of the campaign, AIDS Action and other HIV prevention organizations plan to distribute information about syphilis at nightclubs and other events attended by MSM. In addition, people who cannot afford a syphilis test will receive a voucher for a free test, according to the Globe (Boston Globe, 4/21).