Background:
Syphilis cases among men who have sex with men (MSM) have increased. In addition, the majority of current cases involved patients under the age of 25. One major case in Baltimore City involved 10 African American males diagnosed with syphilis and/or HIV.

Objective:
1) To prevent the spread of syphilis among the MSM population in Baltimore City.
2) To increase counseling, testing and awareness among the MSM population.

Method:
Individuals diagnosed with early Syphilis and HIV were located and interviewed by Disease Intervention Specialist (DIS). Re-interviews and Cluster interviews were conducted to obtain additional information about social-sexual networks. In addition, DIS/Outreach Workers performed prevention activities in areas identified through case interviews.

Result:
Eleven cases that were linked. Investigations revealed; 5 syphilis cases, 4 HIV cases and 2 dually infected cases. Condom use ranged from non-steady to never, which resulted in one patient being diagnosed with primary syphilis and diagnosed 6 months later with HIV. The average patient's age was 21.4 years. All patients were African- American MSM. Internet and chat lines were a primary source of social and/or sexual interactions.

Conclusion:
Typical STD/HIV partner services activities yielded a large network of syphilis and HIV cases among men who have sex with men.

Implications:
More interventions and resources are needed to assist this population in decreasing the spread of syphilis and HIV.