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Background: There are reports of increasing rates of primary and secondary (P&S) syphilis among young African-Americans. CDC field epidemiologists are examining this in different cities. Data are available from New York City (NYC) and Miami-Fort Lauderdale (Mia-FtL).
Objectives:To compare trends of P&S among adolescents in NYC and Mia-FtL 2000-2008.
Methods: Descriptive analysis of P&S cases reported to the NYC Department of Health (DOH) and State of Florida DOH 2000-2008.
Results: From 2000-2008, annual P&S syphilis cases increased in NYC (from 117 to 1067) and Mia-FtL (from 148 to 439) with large increases among males. There was an increase among African-American adolescents males (ages 15-19 years); between 2004 and 2008, annual cases increased in NYC (2 to 34; 2.6 – 43/100,000) and Mia-FtL (2 to 18; 5.1 to 45.2/100,000). Increases were also seen among African-American males 20-24 years in NYC (16 to 65; 24.7-88.1/100,000), and Mia-FtL (14 to 34; 38.1 to 95.0/100,000). For males with P&S in 2008: in NYC, 63% of adolescents were African-American, compared with 35% of cases over 20 years of age (p<0.001); in Mia-FtL, 75% of adolescents were African-American compared with 37% of cases over age 20 (p= <0.001). In 2008, there were at total of 78 adolescent males with P&S in NYC and Mia-FtL; 71% were MSM, 18% tested HIV-positive . Between 2003 and 2008, P&S among African-American female adolescents increased in Mia-FtL (from 2 to 12; 5.1 to 30.5/100,000) but remains low in NYC (2 to 4; 2.6-5/100,000).
Conclusions: African-American adolescent males are an emerging risk group for syphilis in NYC and Mia-FtL. Many are MSM and some are already HIV-infected. Cases are also increasing among African-American female adolescents in Mia-FtL.
Implications for Programs, Policy, and/or Research: Syphilis prevention interventions targeting minority adolescents, including those who are known to be HIV-positive, are necessary.