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Majority of US syphilis cases are now in gay men

Almost two-thirds of syphilis cases in the United States in 2003 were in gay men and other men who have sex with men, according to a study published in the June edition of the American Journal of Public Health. A fall in the incidence of syphilis of over 50% amongst heterosexual men and women between 2000 and 2003 was more than offset by a significant increase in the incidence of the infection amongst men who have sex with men.

Syphilis causes genital ulcers and can facilitate the transmission and acquisition of HIV infection. It can also act as a marker for risky sexual activity, although the infection can be readily transmitted during sexual activities, such as oral sex, which do not involve a significant risk of HIV transmission.

During the 1980s, there was a 54% increase in the incidence of primary and secondary syphilis in the United States, with African-Americans disproportionately affected by the disease. It is thought that the increase in syphilis during the 1980s was tied to the increasing use of crack cocaine and prostitution by some users to fund their habit. By the mid-1990s, however, the incidence of syphilis in the US had fallen sharply, and in 1999 a national syphilis elimination plan was published.

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