Syphilis is on the Rise
The rate of syphilis today is on the rise, being twice that of what it was at its lowest point in the U.S. in the year 2000. Mainly the rise is among men who have sex with men (MSM) bisexual and gay men, while the rates continue to plummet for all other groups. Johns Hopkins University School of Medicine professor Jonathan Zenilman, MD told MedPage Today, “Syphilis has gone from being a disease of heterosexual inner-city folks (prostitutes and their clients, for instance) to primarily a disease of gay men.” There are many important factors to consider here. First, these men generally tend to have a lot of partners. They have unprotected or riskier sex more often and there are a large number of members in this community that are HIV positive. This isn’t exactly a phenomenon without precedent. In fact, we saw a rise in syphilis in the MSM community before, in the free-wheeling 70’s. HIV/AIDS was what put the kibosh on that, and made gay and bisexual men limit the number of partners and take part in protected and less risky sex. The fear of contracting HIV helped and the precautions that ensued helped to decrease the rates of other sexually transmitted diseases. But today the CDC says syphilis has made an impressive comeback. Today the rate is 5.3 cases per 100,000 people, double the rate it was in 2000 when the rate was 2.1 cases per 100,000. Men attributed 91% to the rise in syphilis between 2005 and 2013, with men ages 20 to 24 years old playing a key role.
According to Dr. Zenilman, “When a sexually transmitted disease starts rising, there are three central questions to be asked. Did the bug change? Did the people change? And was there a public health management or structural change?” Gonorrhea evolved, making it antibiotic resistant to many but for a few drugs. But Syphilis hasn’t changed and the treatment remains the same, a single shot of Benzathine penicillin G, and three shots for a secondary case. Syphilis takes two to three weeks to develop after the initial infection. According to Zenilman there’s no reason to be alarmed as “you can pretty much control an epidemic.” But what has changed is society. With the advent of social media it’s easier for those in the MSM community to find each other and have anonymous sex. The fear of HIV contraction has decreased and so gay and bisexual men are having riskier sex than they once did. In San Francisco for instance, HIV testing is routine, it’s become part of the culture. But there’s still a stigma attached to syphilis. Doctors recommend being tested every three to six months for the disease for someone who is MSM. There are many men today who with social media, dating apps and websites meet partners with ease. So they may not have all the information to let someone know about a problem or an issue that may affect their health. San Francisco Department of Public Health has been using AOL chat rooms and other means to let the anonymous sexual partners of infected people know that they need to get tested.