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Georgia's rate of syphilis cases led the nation last year amid a resurgence of the disease among gay and bisexual men, the Centers for Disease Control and Prevention announced Thursday.
The syphilis increase is believed linked to dramatically rising numbers of HIV cases among men who have sex with men.
Atlanta recorded the third-highest urban rate of syphilis, behind San Francisco and Detroit, the CDC said Thursday in a teleconference on sexually transmitted diseases. Georgia was also listed among the top five states for cases of gonorrhea and chlamydia.
While the South has historically been a hot spot for sexually transmitted diseases, Georgia had experienced a decline in the 1990s, a trend experienced across the county.
But the arrow on the nation's syphilis rate charts headed back up in 2001 and 2002 among men, particularly gay and bisexual men, CDC statistics show. At the same time, rates declined among women and African-Americans, although blacks continue to be the population most affected by syphilis, CDC officials said.
Since 1999, CDC has targeted eliminating the disease, particularly in the South and among minority populations. But in the face of the new statistics, the agency acknowledged Thursday, it must redouble education and prevention efforts toward the gay and bi-sexual population.
"The campaign against syphilis is now being waged on two fronts," said Dr. Ronald Valdiseeri, deputy director of the CDC's National Center for HIV, STD and TB Prevention. "We are working on one front to sustain the progress made among populations formerly hardest hit by syphilis, including African-Americans. On the second front, we're combating new challenges among gay and bisexual men." 'Skepticism' cited
Public health officials have been concerned with a recent 25-state study showing a nearly 18 percent increase in HIV diagnoses in the last four years, among men who have sex with men. They have attributed the phenomenon to complacency, recklessness and improved AIDS treatment. "Some of these people have been hearing these [public health] messages for three decades now and are suffering from prevention burnout and skepticism," Valdiseeri said.
In New York City, the number of syphilis cases tripled from 2000 to 2002, with half of the new cases reported in the gay community, Dr. Susan Blank, a New York city health official, said during the CDC teleconference. Nationally, the total number of reported syphilis cases rose 12.4 percent, to 6,863 from 6,103 cases, the CDC said.
Locally, health workers say they are seeing more and more patients with first-time sexually transmitted diseases --- blamed on unprotected sex, drug abuse and the misperception that AIDS is no longer a fatal disease. Such high-risk behavior was likely set off by development of "drug cocktails," which made AIDS a more manageable, chronic disease, instead of an automatic death sentence.
"Since January, the number of clients coming in here with syphilis and gonorrhea has been startling." said Angelle Vuchetich, a nurse and clinic program manager at Grady Memorial Hospital's Ponce de Leon Center, which treats AIDS patients. "It's been mostly gay men but it's crossed all racial and economic lines."
Veronica Hartwell, who oversees STD prevention and education for the Georgia Division of Public Health, said public and private health clinics and gay advocacy groups must emphasize the importance of STD screening.
So far, the state has set up community efforts, such as partnering with churches and other faith-based groups, and targeted venues frequented by men, to get the message out, she said.
"Developing messages that address the correlations between sex and syphilis and offering detailed information about signs and symptoms of early syphilis has worked, especially among women," she said. "We have made progress on that front."
Caused by bacteria that enters the body during sexual contact, syphilis first causes open lesions on the skin that can dramatically increase the spread of HIV. Easily treated
in the long term, untreated syphilis by itself can cause blindness, hearing loss, insanity and often death. But a combination of syphilis and HIV can bring on such severe complications within months, not years, officials said Thursday. Syphilis is easily treated with antibiotics.
According to the CDC, syphilis cases increased 27.4 percent between 2001 and 2002 among men of all races nationally, while there was a 19 percent decline among women overall during the same period. The highest case increase --- 85.2 percent --- was seen among non-Hispanic white men, followed by a 35.6 percent increase among Latino men.
African-American men experienced a nearly 3 percent decline in syphilis cases. However, black men continue to have the highest rate among men --- 13.5 cases per 100,000 compared with 4.5 cases among Latinos and 2.2 percent among non-Hispanic white men, according to the report.
Copyright 2003 The Atlanta Journal-Constitution