Rise in syphilis
attributed to risky gay sex

The national syphilis rate in the United States increased for the fourth consecutive year in 2004, according to new data released Wednesday by the Centers for Disease Control and Prevention on nationally notifiable sexually transmitted diseases. The report, which provides data on three STDs--chlamydia, gonorrhea, and syphilis--also finds that in 2004 the gonorrhea rate reached an all-time low and chlamydia rates increased, possibly due to expanded and improved screening.

The national rate of primary and secondary syphilis--the early stages of the disease that indicate recent infection--has increased every year since an all-time low in 2000. While surveillance data are not available by risk behavior, a separate CDC analysis suggests that approximately 64% of all adult syphilis cases in 2004 were among men who have sex with men, up from an estimated 5% in 1999.

Ronald Valdiserri, acting director of the CDC's National Center for HIV, STD, and TB Prevention, said that may be part of the explanation for the rebound in syphilis, but a primary reason appears to be an increase in risky sexual behavior. "It's very clear that for the last four years, when we've seen an increase it's primarily been in men and predominantly in men who have sex with men," Valdiserri said. "We know that's being fueled by increases in high-risk sexual behavior. We have good data to substantiate that." CDC officials are hoping stronger efforts to educate gay men and others about syphilis will help arrest the infection trend, he said.