Rise in Syphilis Among Men Who Have Sex With Men Not Affecting HIV Rates, But Raises Future Outbreak Concerns
The "discouraging trend" of higher reported rates of unprotected "risky" sex in California, particularly among men who have sex with men, could slow the steadily decreasing rate of HIV infection, according to new surveys by state and University of California researchers, the San Francisco Chronicle reports (Perlman, San Francisco Chronicle, 7/8). The first in a series of reports from the state's Universitywide AIDS Research Program found a tripling of syphilis rates in the state, higher reports of unprotected sex and an increase in methamphetamine use (Chavez, AP/Ventura County Star, 7/8). The report also found that although the number of men in the state seeking treatment for injection drug use declined from 50,000 cases in 1982 to 40,000 in 2002, the number of crack and cocaine users being treated during that period increased from 38,000 to 73,000 (San Francisco Chronicle, 6/8).
According to Dr. George Lemp, director of the program, it is possible that HIV infection rates are already increasing, but remains undetected because of an inadequate reporting system (AP/Ventura County Star, 7/8). An estimated 127,000 state residents are living with signs of HIV infection, but Lemp said the statistics may not be accurate because of insufficient reporting from men seeking sex partners on the Internet; African-American and Latino MSM who do not identify themselves as either gay or bisexual; and the rising number of cocaine and methamphetamine users, who have not reported an increasing HIV infection rate (San Francisco Chronicle, 6/8).
Despite the increase in syphilis rates reported in the state study, HIV rates in Los Angeles and San Francisco among MSM have decreased in recent years, according to a CDC study released Thursday, the AP/Los Angeles Times reports (AP/Los Angeles Times, 6/9). CDC analyzed a 1998-2002 study in the two cities, including HIV and syphilis rates. According to Reuters, syphilis can increase the risk of acquiring HIV (Reuters, 7/8). HIV rates for MSM in San Francisco decreased from 3.9% in 1999 to 2.4% in 2002, and the rates in Los Angeles decreased from 4.8% in 1998 to 4.1% in 2002, CDC found. CDC said the findings could be attributed to the relatively small number of people infected with syphilis and the percentage -- 60% -- of already HIV-positive men who were newly infected with syphilis. However, CDC warned that a continued increase in syphilis outbreaks could still contribute to a rise in HIV among MSM. Scott Holmberg, an epidemiologist with CDC's Division of HIV and AIDS Prevention, noted that cities such as Atlanta, New York and Chicago have seen rises in syphilis without increases in HIV cases. Holmberg added, "We will continue to monitor the situation closely" (AP/Los Angeles Times, 7/9).
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