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Background: Primary and secondary (P&S) syphilis rates have increased since reaching historic lows in 2000. P&S syphilis increasingly affects males, particularly men who have sex with men (MSM). We describe P&S syphilis among U.S. men during 2005–2012.
Methods: We analyzed P&S syphilis case data reported to CDC during 2005–2012. We also analyzed P&S syphilis among MSM using 2009–2012 data from 34 states and District of Columbia where sex of sex partner data was ≥70% complete.
Results: In 2012, men comprised 90.6% of all P&S syphilis cases. During 2005–2012, the P&S syphilis rate among men almost doubled from 5.1 cases per 100,000 men (n=7,383) to 9.3 (n=14,190). Annual rates increased by 11–14% during 2005–2008, 1–2% during 2009–2011, and 14% during 2011–2012. During 2005–2012, rates increased among all age groups and race/ethnicities, but shifts occurred in 2009. During 2005–2009, rate increases were greatest among blacks (14.6 to 29.8) compared to Hispanics (5.0 to 7.6) and whites (3.1 to 3.7). During 2009–2012, rates increased among Hispanics (7.6 to 10.9) and whites (3.7 to 5.0) but decreased among blacks (29.8 to 28.1). Men aged 20–24 had the greatest increase (8.1 to 20.2) during 2005–2009; men aged 25–34 had the greatest increase (17.0 to 22.2) during 2009–2012. Preliminary 2013 data suggest a continuation of these trends.
In 35 areas, MSM comprised 77% of male P&S syphilis cases in 2009 and 84% in 2012. Cases increased among MSM of all ages and race/ethnicities; Hispanics, whites, and men aged 25–34 had the greatest increases.
Conclusions: P&S syphilis rates continue to increase among men with a resurgence of cases in recent years. Although rates remain highest among blacks, recent increases were greatest in Hispanics and whites. P&S syphilis is currently an MSM epidemic.