JUST A LIFESTYLE CHOICE:

Syphilis Relapse: Cases soar in the city (Sharon Lerner, April 16th, 2004, Village Voice)

In 1998, syphilis rates were so low the Centers for Disease Control announced a plan to completely eliminate the disease. The agency began an all-out prevention campaign, stepping up syphilis surveillance in New York City and the few counties across the country where it still existed. By 2000, the sexually transmitted infection was at its lowest point since 1941. Soon, the country's top doctors predicted, the dread illness that afflicted Henry VIII, Ivan the Terrible, and even a pope would be nothing more than an unpleasant memory, gone the way of smallpox and other eradicated diseases.

But just six years after the bold elimination plan, syphilis is back. Nationally, cases in gay men shot up more than 15 percent in 2001. In New York City, the number of people with symptoms of syphilis has gone up even further, increasing a total of more than 500 percent between 1998 and 2003, from 82 to 531 people, according to preliminary health department data. As of last week, there were an additional 953 people infected with syphilis but without apparent symptoms, according to the health department. Many more cases of syphilis likely go unreported. [...]

Frightening as the statistics are, this latest outbreak of syphilis may be more significant as a harbinger of the next stage of the city's HIV epidemic than as a direct health threat. "In my mind, it's a marker that people are having unprotected sex," says Dawn Harbatkin, medical director of the Callen-Lorde Community Health Center. "In the relative scheme of things, I'm more worried about crystal meth use and new HIV infections. But I think they're all linked. It's not just the syphilis, but what it means for these other issues."

Harbatkin's fears are founded. In a health department study comparing 88 men with infectious syphilis to a control group, more than half of the infected men reported barebacking, or having anal sex without condoms. Drugs are also clearly implicated in the recent outbreak. One-third of men with syphilis reported using Viagra. And infected men were also more likely to use crystal meth, poppers, and pot.

The study also found that men with syphilis were more than twice as likely to have HIV. "It's a potentially explosive situation for the spread of HIV," says the health department's Blank. "People with HIV are leading longer and healthier lives than was possible in the '80s and early '90s. Part of that involves feeling good—and feeling good enough to have sex." And having active syphilis makes it easier to both pass on and contract HIV when you have sex. Being HIV-positive can also affect the course of syphilis, shortening the length of time it takes for the bacteria to move through their cycles and cause real damage.

With so many folks telling them they're just like everyone else, they start believing it--with predictabley tragic results.

Posted by Orrin Judd at April 14, 2004 7:47 AM