TP 26 Primary and Secondary Syphilis in Men United States, 20052012

Tuesday, June 10, 2014
Exhibit Hall
Monica Patton, MD1, John R. Su, MD, PhD, MPH2, Robert Nelson, MPH2 and Hillard Weinstock, MD, MPH3, 1Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, 2Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 3Division of STD Prevention, CDC, Atlanta, GA

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 20052012.

Methods: We analyzed P&S syphilis case data reported to CDC during 2005–2012. We also analyzed P&S syphilis among MSM using 20092012 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 20052012, 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 1114% during 20052008, 12% during 20092011, and 14% during 20112012. During 20052012, rates increased among all age groups and race/ethnicities, but shifts occurred in 2009. During 20052009, 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 20092012, 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 2024 had the greatest increase (8.1 to 20.2) during 20052009; men aged 2534 had the greatest increase (17.0 to 22.2) during 20092012. 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 2534 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.