Syphilis up among US minority gay and bisexual men: Report

NEW YORK - The rising U.S. syphilis rate appears to be disproportionately striking minority gay and bisexual men, the U.S. Centers for Disease Control and Prevention reported.

The increase in the disease, which has been on the rise in the U.S. since 2000, raises concerns not only because of syphilis itself, but also because the infection makes people more vulnerable to contracting HIV, the virus that causes AIDS.

The new findings, reported in the Annals of Internal Medicine, show that minorities - and young men, in particular those who are gay or bisexual - are being hit hardest by syphilis, which can be easily cured by antibiotics in the early stages but may not show symptoms early on.

The bottom line in prevention among gay and bisexual men is awareness, said lead researcher John Su, a medical epidemiologist at the CDC.

"First, you have to know you're at risk. Then have a frank discussion about it with your healthcare provider," he told Reuters Health.

Using data from 27 states, CDC researchers found that between 2005 and 2008, the syphilis rate among black gay and bisexual men rose at an eight-times faster pace compared to their white counterparts.

Hispanic gay and bisexual men, meanwhile, had more than twice the increase of white men.

By 2008, the syphilis rate among black gay and bisexual men was 19 per 100,000. Those figures were just over 7 per 100,000 among Hispanic men, and 4 per 100,000 among white men.

What's more, there has been a shift in the age group most affected by syphilis, with teenagers and men in their 20s showing the biggest increase since 2005. Ten years ago, outbreaks of syphilis were mainly reported among gay and bisexual men in their 30s.

"Rates of primary and secondary syphilis disproportionately increased among black and Hispanic men who have sex with men(MSM), compared with white MSM, and among young men MSM," Su and others wrote.

Racial disparities in syphilis and other sexually transmitted diseases (STDs) have long been seen among U.S. men in general, so the current findings are not especially surprising. But the magnitude of the racial gap is worrisome, Su said.

While it is hard to pin down the precise reasons, it could reflect factors such as lower incomes and education levels, and poorer access to healthcare - in other words, the same race-related disparities seen among U.S. residents in general.

Recent studies have also suggested that young gay and bisexual men are increasingly engaging in risky sex, including having unprotected intercourse and multiple partners.

Su said it's recommended that all sexually active gay and bisexual men be tested at least once a year for syphilis and other STDs, including HIV and gonorrhea. Staying in a monogamous relationship with a partner who has been tested, and using condoms consistently, reduce the chances of contracting syphilis, he added.

But the recent re-emergence of syphilis may require "novel"public health responses, according to an editorial published with the study.

"For example, many MSM with newly diagnosed syphilis or HIV met their sexual partners recently on the Internet," write Kenneth Mayer and Matthew Mimiaga of the Boston-based Fenway Institute, which specializes in healthcare for gay, bisexual and transgender patients.

Education and screening efforts, as a result, need to target men online and at clubs, bars and bathhouses - anywhere that men go.

Su agreed that steps such as using the Internet to spread health messages are promising. He also pointed to programmes that use "peer educators," such as lay people trained to help get messages out to their community.

About 15 per cent of people with untreated syphilis eventually develop long-term complications, the CDC said. Those include damage to the brain, nerves, heart and blood vessels, which can prove fatal.