Syphilis Rates Among Gay and Bi Men Are Catastrophic

According to new research, the rates of syphilis among gay and bi men is 107 times higher than among straight men. Rates were different in each state, ranging from 39 times higher in Minnesota to an astounding 342 times higher in Hawaii. 

This was the first study of its kind where researchers were able to include data on a state-by-state basis, noted MedPage Today reporting on a 2016 STD Prevention Conference  presentation by Dr. Alex de Voux, an epidemiologist, from the Centers of Disease Control and Prevention’s STD Prevention Surveillance department.

Researchers analyzed 44 states and discovered that in 2015, syphilis cases were 19 percent higher than in 2014, and in 2014 the number of case were 15 percent higher than they’d been in 2013. In other words, the number of cases rose 34 percent in just two years.

Although syphilis was once nearly eliminated in the U.S., cases are on the rise, especially among gay and bi men. In 2015, there were 17,887 cases among men — 12,118 of whom were men who had sex with men, while 2,866 only had sex with women, and 2,903 didn’t report the sex of their partners. 2,030 of the cases were among women. Based on population, de Voux said that 309 out of 100,000 gay and bisexual men have syphilis versus 2.9 out of 100,000 other men. That’s a significant difference.

De Voux told MedPage Today that the U.S. is “16 years into this outbreak among MSM,” yet this data has only recently become available. “So I think it’s very valuable. Until you can quantify a problem it’s hard to get politicians and other people to listen.”

As syphilis cases are on the rise, cases of ocular syphilis more than doubled between 2014 and 2015 (rising from 20 cases to 43). Plus reported on several clusters of ocular syphilis that occurred among gay men (over half of whom were also HIV-positive) in Washington and California.

In the last few years, doctors have discovered that ocular syphilis might be linked to HIV. According to Dr. Anne Cope from the CDC, patients who were HIV-positive were almost twice as likely to have ocular syphilis, while researchers in North Carolina found that the eye disease was more often accompanied by an HIV diagnosis than all other forms of syphilis. It’s a nasty co-morbidity, and can lead to permanent vision loss or complete blindness. Syphilis itself can also put someone at higher risk of becoming HIV-positive.

Syphilis can be cured with antibiotics, but once damage has been done by the disease it’s irreversible. Untreated, the CDC reports external symptoms of the disease frequently go away, but without treatment the disease can progress to late stage syphilis, when it can cause difficulty coordinating muscle movements, paralysis, numbness, blindness, dementia, organ damage, and death.  

Syphilis is passed from person to person via direct contact with a syphilis sore, which can occur on the genitals, anus, lips, as well as in the mouth or rectum. Because pretty much any sexual activity can transmit syphilis, the only way to completely avoid it is to stop having sex. Since most of us aren’t willing to go to those extremes, the CDC recommends limiting sexual partners and using latex condoms or dental dams. However, they also caution, “Sometimes sores can occur in areas not covered by a condom, so you could still get syphilis from contact with these sores, even if you are wearing a condom.”

An even more common STI, gonorrhea, is now on the verge of becoming untreatable, as strains have become resistant to all current antibiotics.

That’s just one more reason the CDC recommends, “All sexually active gay, bisexual, and other men who have sex with men should be tested regularly for STDs.”