Severe Form of Syphilis Recorded Among MSM, MMWR Study Says

From the Kaiser HIV/AIDS Daily Report

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=45953

A serious form of syphilis is appearing among some men who have sex with men, according to a study published in the June 29 edition of CDC http://www.cdc.gov/ 's Morbidity and Mortality Weekly, Reuters http://www.alertnet.org/thenews/newsdesk/N28314225.htm reports. Symptomatic early neurosyphilis is a rare manifestation of syphilis that usually occurs within the first year of infection, according to Reuters. Although syphilis can be cured with antibiotics in its early stages, neurosyphilis can lead to blindness or stroke, according to Thomas Peterman, a study author from CDC's Division of STD Prevention http://www.cdc.gov/nchstp/dstd/aboutdiv.htm .

Peterman and colleagues tracked 49 HIV-positive MSM who had symptomatic early neurosyphilis in Chicago, Los Angeles, New York city and San Diego from January 2002 to June 2004. Sixty-three percent of the participants were non-Hispanic whites, 18% were non-Hispanic blacks and 14% were Hispanic. Their average age was 38. CDC cited the study as further evidence that MSM, many of whom are HIV-positive, are the driving force behind the increase in the number of cases of syphilis in the U.S. during the past 10 years (Dunham, Reuters, 6/28).

According to CDC officials, the number of syphilis cases in the U.S. reached an all-time low in 2000. However, the number of cases has risen annually from 2000 to 2005, the most recent year for which the agency has figures. CDC analysts estimate that in 2000, MSM accounted for 7% of syphilis cases in the country but accounted for more than 60% in 2005. According to CDC, syphilis incidence in the overall population was 2.1 cases per 100,000 people in 2000, compared with three cases per 100,000 people in 2005, or 8,724 cases (Kaiser Daily HIV/AIDS Report http://www.kaisernetwork.org/daily_reports/rep_index.cfm?hint=1&DR_ID=44746 , 5/8).

The study's findings also indicate that some MSM are engaging in sexual practices that can spread HIV and other sexually transmitted infections. "These are primarily infections that people are probably getting because they're not using condoms," Peterman said. He added that there are a "number of studies that continue to show that there are some HIV-infected and some uninfected men who have sex with men who continue to have large numbers of (sexual) partners and anonymous sex. This is one of the consequences of that." According to Peterman, study participants in some cases said that because they have HIV, they did not need to practice safer sex. "I think the bigger message is that we need to get control of syphilis," Peterman said, adding that curbing the STI would "require safe-sex behavior, reducing the number of partners and using condoms with those partners." He recommended that MSM get tested for HIV and other STDs at least once annually (Reuters, 6/28).

Online http://www.kaisernetwork.org/images/paper_icon.gifThe study is available online http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5625a1.htm .