Syphilis Cases Increasing in New York City, Could Fuel Increase in HIV Cases

The New York City Department of Health and Mental Hygiene in the first three months of 2007 recorded 260 syphilis cases, including 10 among women, an increase in the number of cases recorded during the same period in 2006, the New York Times reports. According to the Times, syphilis is most common among men who have sex with men, although the sexually transmitted infection is increasing among women in the city (Kershaw, New York Times, 8/12).

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, 7/2). According to the Times, syphilis incidence in New York City in 2005 was 7.7 cases per 100,000 people.

Most new syphilis cases in the city occur among blacks or Hispanics, although syphilis among whites is increasing at a faster rate than among other groups, according to a recent survey. Syphilis incidence among white men in the first quarter of 2007 was three times the incidence during the same period in 2006, the Times reports.

According to officials with the health department, the increase could be fueled by MSM who also have sex with women. Stuart Berman, a CDC epidemiologist, said that men with syphilis living in New York City reported bisexual behavior more than men with syphilis in other cities. According to federal health officials, people with syphilis are two to five times more likely to contract HIV because of open sores caused by the infection.

Health experts have warned that an increase in syphilis cases could contribute to an increase in HIV cases, the Times reports. Perry Halkitis, a professor of applied psychology at New York University, said there "[m]ost certainly" would be an "increase in HIV transmission." Drug use that can contribute to increased sexual activity and unsafe practices, risky sex among HIV-positive people, complacency about the risks of HIV and decreased condom usage all could be contributing to the increase in syphilis cases, according to federal and local health officials. Susan Blank, the city commissioner for sexually transmitted disease prevention and control, said that the health department is alerting residents and health care providers about the importance of syphilis screening. The health department is offering no-cost and confidential testing at all of its public clinics, Blank said. Some health officials say that the increase in cases among women underscores the need for people to learn their partners' sexual history because some women might not know that their partners have sex with men (New York Times, 8/12).