Once nearly eliminated in the United States, syphilis is making a comeback among men who have sex with men.
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Six years ago, rates of syphilis infection began increasing in Minnesota. A total of 114 new cases of early syphilis were reported to the Minnesota Department of Health (MDH) in 2007, up from 104 in 2006. Early syphilis represents the most infectious stage of syphilis and is the greatest concern for health officials.
“Although a serious disease if left untreated, syphilis remains a relatively rare disease for most Minnesotans,” said Bill Burleson, Syphilis Elimination Coordinator at MDH. “That said, it’s no longer that rare in certain communities, particularly among gay and bisexual men.”
In 2001, only five new cases of early syphilis were reported among gay and bisexual men in the state. Now, for 2007, 103 new cases of early syphilis were reported, an increase of 30 percent over the previous year. Gay and bisexual men now represent 90 percent of all new infections.
Of special concern is that 44 percent of newly infected gay and bisexual men were also HIV positive in 2007. “We know that someone who has syphilis is more likely to acquire HIV, if they don’t already have it, or pass HIV on to someone else if they are positive,” Burleson said. “Plus, there is the potential for greater health impacts and treatment failures when someone with HIV gets syphilis.”
The most commonly reported risk factors among those with syphilis in 2007 were meeting partners on the internet, anonymous sex, and no condom use. Also, new infections continued to be centered within the Twin Cities metropolitan area, with only three cases appearing in Greater Minnesota.
“Syphilis is both preventable and curable,” Burleson said. “We need to educate ourselves and stay informed in order to fight it. For those gay and bisexual men who are sexually active with multiple partners, especially if they met those partners on the internet, this is no longer a rare disease. It’s important to know the risks, use condoms, and know what to look for if there’s a chance you or a partner may be infected. Those at risk, even if they don’t have symptoms, need to get tested for syphilis every six months, and perhaps even more often for those who are HIV positive,” he said.
As part of its response to the continued increase in syphilis rates, MDH created the Healthcare and Men Who Have Sex with Men: Challenges and Opportunities program. The program offers resources, trainings, and materials to help clinics examine and increase their cultural sensitivity for gay and bisexual male patients. Information about this program and an assortment of MSM health informational materials and lobby posters are available at the Syphilis Elimination Web site at: www.health.state.mn.us/sep.
The Syphilis Elimination Project is part of a nation-wide effort by the Centers for Disease Control (CDC) bringing together health care providers, policy makers, community leaders and state and local public health agencies to reduce syphilis rates in the United States. The effort is funded by the CDC.