4B1 Rates of Primary and Secondary Syphilis By State Among Men Who Have Sex with Men - United States, 2014

Thursday, September 22, 2016: 3:00 PM
Salon B
Alex de Voux, PhD1, Sarah Kidd, MD, MPH2, Jeremy Grey, PhD3, Eli Rosenberg, PhD3, Thomas Gift, PhD1, Hillard S. Weinstock, MD, MPH2 and Kyle Bernstein, PhD1, 1Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 2Division of STD Prevention, CDC, Atlanta, GA, 3Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA

Background:  In the United States, cases of primary and secondary (P&S) syphilis have increased among men who have sex with men (MSM) with MSM accounting for 61% of all P&S syphilis cases in 2014. Until now, we have been unable to calculate state-specific rates of P&S syphilis among MSM because state-level MSM population estimates were not available.

Methods:  Using 2014 population estimates of the number of adult MSM (≥ 18 years) by state based on a recent modeling study, we calculated rates of P&S syphilis among adult MSM. 2014 P&S syphilis case counts were obtained from national case report data routinely reported to CDC, which includes sex of partner. For states reporting sex of partner for at least 70% of male P&S syphilis cases, we estimated state-specific rates of P&S syphilis among adult MSM and compared them to rates among adult men reporting a female sex partner only.

Results:  Among 40 states reporting sex of partner for at least 70% of male P&S syphilis cases, the overall rate among adult men was 15.0 per 100,000 in 2014. The rate among adult MSM was 271.6 cases per 100,000 (state-specific range: 20.7 to 606.4 per 100,000) and the rate among adult men reporting a female sex partner only was 2.2 per 100,000 (state-specific range: 0 to 6.9). Overall the rate of P&S syphilis among MSM was 124 times the rate among adult men reporting a female sex partner only and ranged across states from 14.9 to 450.4.

Conclusions:  These are the first state-specific rates of P&S syphilis for adult MSM in the US. Rate ratios comparing rates of P&S syphilis among adult MSM to adult men reporting a female sex partner only showed dramatically higher rates among MSM and better illustrates the disproportionate impact of P&S syphilis among MSM in the US.