PNP and IPN: Impact of the Internet on a P&S Syphilis Outbreak in Central New York and Its Control

Background:
Using the Internet to meet sex partners has been linked to increases in primary and secondary (P&S) syphilis among men who have sex with men (MSM). In a P&S outbreak in Central New York (CNY), the Internet also served as an intervention strategy.

Objective:
To describe 1) a P&S syphilis outbreak among MSM in CNY linked to the internet and 2) use of Internet Partner Notification (IPN) in its control.

Method:
Persons with early syphilis were interviewed by CNY Disease Intervention Staff for disease intervention including partner elicitation.

Result:
The initial case report in January 2006 resulted in a total of 67 partners elicited, 52 unduplicated, and 12 clusters. Of the five linked social networks, persons in four used the Internet to locate Party and Play (PNP) venues for meeting sex partners. IPN was the initial method of contact in 20/52 (38%) partners with the following outcomes: 4/4 (100%) infected brought to treat; 1/2 (50%) previously-treated; 10/19 (53%) preventively treated; 1/4 (25%) not infected, 3/4 (75%) unable to locate; and 1/2 (50%) refused examination. An additional 17 had insufficient information to initiate. Investigation identified 3 Primary, 3 Secondary, 1 Early Latent syphilis cases. Co-infections included five (71%) HIV cases (four pre-existing, one new), one gonorrhea, and one Hepatitis B.

Conclusion:
In this P&S outbreak, the internet contributed to high risk behavior and disease transmission but was also integral to locating partners.

Implications:
Participants in this presentation will learn about the role of the internet in a recent outbreak of P&S syphilis and the outcomes associated with IPN compared to traditional PN in controlling this outbreak.