New Data Show Syphilis Threatens the Health of a New Generation of Gay and Bisexual Men

Black and Hispanic men who have sex with men bear the greatest syphilis burden

Today, CDC researchers published the first national-level analysis that compares trends in primary and secondary (P&S) syphilis among men who have sex with men (MSM) by age group and race/ethnicity; the analysis found that recent increases in P&S syphilis in this population are occurring mostly among young MSM, aged 15-29 years. P&S syphilis reflects recent infection with the sexually transmitted disease, and can facilitate HIV transmission. The analysis also showed that black and Hispanic MSM bear a greater burden of P&S syphilis, with rates 8 and 2.4 times the increases of white MSM, respectively.

From 2005-2008 in the 27 states included in the analysis, increases in P&S syphilis were highest among MSM aged 15-19 years (160%), 20-24 (117%), and 25-29 (69%). The findings of the study are especially troublesome because these observed increases in P&S syphilis parallel similar increases in HIV infection, meaning young gay and bisexual men are increasingly becoming infected with these diseases earlier in life. In the study, authors mention several behaviors that may increase the risk of acquiring syphilis, such as unprotected sex, sex with multiple partners, and using the Internet to recruit partners. Authors also point out that disease prevalence, sexual networks, and a range of social factors, including stigma and homophobia, are factors that may be contributing to the increases in black and Hispanic MSM acquiring syphilis.

Rates of P&S syphilis reached historic lows in the United States in 2000, but began increasing in men the following year. For this analysis, researchers sought to describe, on a national level, disparities of P&S syphilis by age group and race/ethnicity among MSM. Study authors point to the need to provide MSM, especially young, black and Hispanic MSM, with the tools they need to prevent syphilis and other STDs. These increases in P&S syphilis are a clear indication that new interventions are needed to reach these populations, including services that emphasize confidentiality and incorporate the Internet. Authors also suggest that healthcare providers be sensitive to issues specific to young gay and bisexual men, and offer counseling about safer sex and perform at least annual testing for syphilis and HIV.

Su J., Beltrami J., Zaidi A., Weinstock H.; Primary and Secondary Syphilis Among Black and Hispanic Men Who Have Sex With Men: Case Report Data From 27 States. Ann Intern Med. 2011;155:145-151. doi: 10.7326/0003-4819-155-3-201108020-00004. Retrieved from http://annals.org/aim/article/479623/primary-secondary-syphilis-among-black-hispanic-men-who-have-sex.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES