The Centers for Disease Control released its annual report on sexually transmitted diseases earlier this month and found that the number of cases of syphilis, which disproportionately affects men who have sex with men (MSM), is at its highest in more than a decade.
The CDC’s 2008 Sexually Transmitted Disease Surveillance report found that syphilis was the third-most-reported STD in the country, with 13,500 cases reported last year, an increase of more than 15 percent since 2007. Rates of syphilis are at their highest since 1995.
Approximately 63 percent of the reported syphilis cases last year were among MSM; in 2000, MSM accounted for only 4 percent of the syphilis cases.
Nationally, white MSM reported the highest rate of primary and secondary syphilis, followed by African-American MSM. African-American heterosexual men and women, the next-highest demographic, contracted the disease at a rate of more than double that of white and Hispanic heterosexuals.
Pennsylvania reported 902 cases of the disease and is ranked 30th on the list of states in terms of number of syphilis cases, with Louisiana, Alabama and Georgia taking the top three spots, respectively. Philadelphia County reported 150 syphilis cases last year and is ranked 19th out of 70 counties nationally, with Los Angeles County reporting the highest number of cases.
Brian Green, executive director of The Safeguards Project, said that locally his organization, as well as the city health department’s syphilis taskforce — comprised of local LGBT organizations like Safeguards, COLOURS, The Attic Youth Center and Gay and Lesbian Latino AIDS Education Initiative, as well as other mainstream health groups — have seen an increase in syphilis among MSM.
“The taskforce had been focusing a lot on syphilis specifically within the MSM community, but within the last year that focus has broadened a bit because there were increasing cases among heterosexual women, but just in the last quarter there’s been another uptick again of MSM cases,” Green said. “It’s something that we’re involved in, that we’re aware of and that we know that other cities are experiencing too.”
The taskforce works to spread awareness about the disease among high-risk populations and healthcare providers, and Green said Safeguards has noticed that MSM seem to be more conscious of the epidemic, as it’s becoming more common for them to request a syphilis test. However, he noted, “more men are asking to be tested but, unfortunately, more of them are testing positive.”
The rate of syphilis among MSM is of particular concern, as there is a high correlation between those who are positive for syphilis and for HIV.
“It goes both directions. If you have syphilis and have an open sore, it increases the likelihood that you’d be infected if you were exposed to HIV,” Green said. “And if you’re already HIV-positive, you’re more susceptible to getting syphilis.”
For the past two years, the CDC has recommended that sexually active MSM be screened for syphilis and other STDs every three months, which Green said is important, considering that syphilis is sometimes hard to detect.
“You can get infected with syphilis and not show symptoms. Not everyone has the hallmark open sore,” Green said. “When you first get infected, you may just have a rash that goes away quickly and people may not recognize what it is. That’s why the healthcare providers need to be more aware of this epidemic and why people need to get tested every three months.”
Chlamydia continued to be the most commonly reported STD in the country, followed by gonorrhea, both of which were reported at high rates in Philadelphia.
Philadelphia County ranked fourth out of 54 counties in the country with 17,012 cases of chlamydia in 2008; Allegheny County was the only other Pennsylvania region included on the list, coming in at number 41. Philadelphia County had the sixth-highest number of gonorrhea cases out of 71 counties, with 4,950 reported cases last year. Allegheny County ranked 24th.
Last year, there were more than 1.2-million cases of chlamydia reported nationwide, up from 1.1 million the previous year, but CDC researchers estimated that there could be as many as 2.8-million cases each year. Women ages 15-19 reported the highest incidence of chlamydia, but the CDC cautioned that the rate of the disease among men and women may be similar, as women have a higher rate of STD testing.
The number of gonorrhea cases slightly decreased between 2007-08, from 355,991 to 336,742. Like chlamydia, gonorrhea was also reported most frequently in women ages 15-19.
For more information or to read the full report, visit www.cdc.gov.
Jen Colletta can be reached at [email protected].