Homosexual men boost increase in syphilis rate

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The syphilis rate among U.S. men soared 81 percent between 2000 and 2004, primarily as a result of increases in reported cases among homosexual males, federal health officials reported yesterday.

While the rate among men nearly doubled during that time -- from 2.6 per 100,000 to 4.7 -- the syphilis rate among women fell from 1.7 to 0.8 per 100,000 from 2000 to 2003. It remained stable in 2004, marking the end of a 13-year decline.

"The vast majority of the increase is attributable to a resurgence of syphilis among men who have sex with men ... syphilis rates continue to increase among [this group]," said Dr. J.F. Beltrami and other authors of a report from the Centers for Disease Control and Prevention's National Center for HIV, STD and TB Prevention.

They also pointed out that sexually active bisexual men "likely contribute to syphilis among women."

Of the nearly 8,000 cases reported in 2004, "approximately 84 percent occurred among men," they wrote, and the CDC estimates that nearly 65 percent of those cases resulted from men having sex with other men.

The authors also said reported increases in incidence of syphilis among homosexual behavior have been characterized "by high rates of HIV co-infection, high-risk sexual behavior and use of drugs such as methamphetamines."

"Syphilis increases have occurred among [homosexual and bisexual men] who have met sex partners in Internet chat rooms," the researchers said. They stressed the need for more study of how the Internet affects the spread of sexually transmitted diseases and how it might be used as an STD prevention tool.

A separate analysis in the CDC's Morbidity and Mortality Weekly Report found that use of methamphetamines is also an HIV risk factor among heterosexual men. Using data from a large population-based study of heterosexuals aged 18 to 35 living in five northern California counties, researchers found that those who had recently used meth were more likely to "practice high-risk sex" than nonusers.

High-risk sex included having casual or anonymous sex partners, multiple sex partners and partners who used injectable drugs. While 15.5 percent of meth users said they had received drugs or money in exchange for sex, only 3.5 percent of nonusers said they had ever done so.

In the syphilis study, CDC investigators said that from 2001 to 2004, disease rates were higher among blacks and Hispanics than among whites. In 2003, the rate among blacks was 5.1 times higher than whites and was 5.6 times higher in 2004.

"But substantial increases occurred only among black men," not black women, the authors wrote.

By region, the South saw the highest increase in syphilis rates between 2003 and 2004: 16 percent. That marked the first time since 1991 that syphilis rates increased in that region of the country.

"In each region, [primary and secondary] syphilis rates among black men and women exceeded those of whites and Hispanics," they concluded.

The national rate of primary and secondary syphilis climbed 8 percent -- from 2.5 per 100,000 population to 2.7 -- between 2003 and 2004, marking the fourth consecutive annual rise in this sexually transmitted disease, which health officers are focused on eliminating.