Syphilis Cases Rising Among US Gay And Bisexual Men After Near-Total Elimination A Decade Ago

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Despite near-total elimination of the sexually transmitted venereal disease syphilis more than a decade ago, the Centers for Disease Control and Prevention (CDC) reports that rates have made a steep jump over the last eight years.

The new study released Thursday offers a snapshot of the disease’s prevalence across multiple demographics, including gender, race, sexual orientation, age, and geographic region. Where syphilis was once on the brink of eradication in the year 2000, when the rate was a mere 2.1 cases per 100,000, overall prevalence had increased to 5.3 cases per 100,000 people by 2013. Researchers working with the CDC speculate the greatest contributing factor has been the transmission between men who have unprotected sex with other men.

Gail Bolan, director of the CDC’s Division of STD Prevention, told Reuters that prevention efforts that have largely worked on heterosexual people have not resonated as well with homosexual populations. “We’ve got to re-evaluate and look at new approaches that we can use to drive these rates down,” she said.

Men made up the largest portion of syphilis patients in 2013, at 91 percent of all primary and secondary cases (a breakdown that refers to the severity of the disease). Over the eight-year study period, rates increased from 5.1 people to 9.8 per 100,000. Women, meanwhile, rose from 0.9 in 2005 to 1.5 in 2008, then back down to 0.9 again by 2013. Overall, the number of reported U.S. syphilis cases nearly doubled, from 8,724 to 16,663.

Syphilis is not always a lethal disease; however, it can lead to severe disabilities such as blindness and stroke. Initially, syphilis is contracted via open sores during vaginal, anal, and oral sex. Owing to its morbid nickname of “the great imitator,” syphilis sores aren’t always severe in the beginning. Many people think nothing of a red bump, which could be a harmless cut or mild irritation. Later, however, the sore develops into splotchy rashes and more familiar symptoms, such as a sore throat or headaches.

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But it’s during the latent and late stages, which occur after having had syphilis for 10 to 30 years, when difficulties with muscle movement, dementia, and paralysis may begin to set in. In the rare cases that patients’ internal organs begin to suffer, Bolan said, the disease can result in death. Typically, the right mix of antibiotics can cure a syphilis infection, although the damage that’s already been done could be permanent.

To prevent further spread of the disease, the CDC recommends a two-fold approach involving doctors and patients. Clinicians have the responsibility of educating their patients — instructing them on the importance of latex condom use, committing to trusting and perhaps even monogamous sexual relationships, and general knowledge about the disease’s risks. Patients, meanwhile, must take this advice to heart and genuinely practice it.

“Public health practitioners might want to consider focusing on efforts to strengthen linkages with practicing physicians,” the report adds. This would be done in order “to improve case identification and reporting, partner-notification programs, and outreach” primarily to men who choose to have sex with other men.

 

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