Syphilis Outbreak Among Men Who Have Sex with Men (MSM) in Puerto Rico (January-June, 2008 vs. 2009)

Background: Since 2004, STD Surveillance Office notified an increase in the reported cases of primary and secondary (P&S) syphilis cases among males. For 2008 and first semester 2009 was identified an increase in the number of P&S syphilis cases among men who have sex with men (MSM), many of whom are co-infected with HIV.

Objectives: Describe the outbreak of P & S syphilis among MSM in Puerto Rico.

Methods: We reviewed case interview records and syphilis surveillance data for P&S syphilis cases reported to the  STD Surveillance Office as P & S syphilis from 2008 through June 2009.

Results: From January - June (2008 vs.2009) P&S syphilis cases among MSM increased 31 %.in Puerto Rico.  Of those MSM diagnosed with P & S syphilis, 26.5 % were co-infected with HIV, with 20 - 44 years old. A 46 % of MSM reported use of Internet to seek partners. During first semester of 2009 the municipalities with most cases reported were San Juan, Carolina and Toa Baja.

Conclusions: The prevalence of HIV among those patients with P & S syphilis indicating unsafe sexual activities among these men. Knowledge of HIV co-infection in patients with syphilis and sexual behavior is an important factor for clinical management, partner follow-up and disease prevention. Internet has identified as a common venue for meeting sex partners and planning participation in risky sexual behavior among MSM diagnosed with P & S syphilis.

Implications for Programs, Policy, and/or Research: These data highlight the urgent need to identify more effective prevention methods for MSM in Puerto Rico.