Gay and Bi Men Account for 75% of All Syphilis Cases

At the end of 2014 the Centers for Disease Control and Prevention released its sexually transmitted disease surveillance data for the previous year, 2013, showing the rates for primary and secondary syphilis, which is the most infectious stage of syphilis, increased by an alarming 10 percent.

“This second year of double-digit increases of syphilis rates is completely unacceptable and also significantly intersects with our HIV epidemic,” says William Smith, executive director of the National Coalition of STD Directors. “This continues to affect populations already disproportionately impacted by all STDs, including HIV, most notably gay men and other men who have sex with men (MSM).”

The coalition notes that the rate of syphilis in 2013 was the highest recorded since 1996.  That 10 percent increase in syphilis rates in 2013 was almost entirely increases in men, mainly gay and bi men; no overall increase was seen in women that year. Smith also reports that syphilis and HIV coinfection among gay and bi men is so common that over half (52 percent) of MSM with primary and secondary syphilis also have HIV and that MSM account for 75 percent of the primary and secondary syphilis cases reported to the CDC.

There is good news on the horizon, though. The Food and Drug Administration has just approved Syphilis Health Check, the first rapid syphilis test to receive a waiver for use outside of traditional laboratory settings, which Smith calls a “game-changer in syphilis testing and prevention, allowing for a much quicker response, similar to what was previously available for HIV testing for over a decade.”

Dr. Susan Philip, immediate past chair of the coalition’s board of directors and STD controller for San Francisco, says that in outreach settings with high-risk populations, “every rapid HIV test being run should have a rapid syphilis test run concurrently.”
Test results are available in 12 minutes, and the tests can now be run in STD clinics, ERs, jails, and HIV testing centers, among other places.