Epidemiological Characterization of Syphilis Cases in Men at An Urban STD Clinic in Mississippi, Jan 2004 – Dec 2008

Background: Men who have sex with men (MSM) and African Americans (AA) are two demographic groups that have significantly been affected by recent increases in syphilis rates across the United States. 

Objectives: To perform an epidemiological characterization of syphilis cases at an urban STD clinic in Mississippi during the years 2004-2008.

Methods: Medical records of all patients diagnosed with syphilis at a Jackson, MS STD clinic between January 2004 and December 2008 were reviewed and abstracted. Variables abstracted included demographical information, sexual behavior, history of prior STD (including HIV), and current STD diagnosis.

Results: A total of 178 patients were diagnosed with syphilis during the selected time period, 148 (82.6%) were men. Primary or Secondary syphilis was diagnosed in 44.2% of these men. The mean age was 31 ± 10.9 years. Of these men, 39.5% were heterosexual and 60.5% reported sex with men or reported sex with men and women (MSMW); 94.6% were AA. Heterosexual men with syphilis were significantly older, more likely to report never using condoms, and have a history of Chlamydia infection. MSM/MSMW were more likely to be HIV positive, to have reported oral or anal intercourse, and be diagnosed with gonorrhea and/or HIV at the time of syphilis diagnosis. These two groups did not differ in syphilis stage, mean number of sexual partners, prior history of syphilis or gonorrhea, or current Chlamydia diagnosis.

Conclusions: AA men diagnosed with syphilis in this STD clinic have distinct epidemiological characteristics that are determined by their sexual orientation. These differences may reflect two parallel syphilis epidemics in this population.

Implications for Programs, Policy, and/or Research: More research is needed to further characterize syphilis transmission among AA men with different sexual orientations.