SAN FRANCISCO — The National Centers for Disease Control and Prevention and the San Francisco Health Department announced that they found “crescendoing” STD rates among gay and bisexual men, while rates of infection consistently fell among women, March 10.
In particular, the increased syphilis rates among gay and bisexual men drew much attention; the federal government had hoped to virtually eradicate the disease during this decade, but the spiraling growth among gays have scuttled those plans.
For three consecutive years through 2003, syphilis rates among women have fallen by 50 percent but have increased by 65 percent among men. Among women in 2003, there were 1,229 syphilis cases reported, down from 2,445 in 2000. Among men in 2003, there were 5,844 cases, up from 3,532 in 2000. Gay men accounted for more than 60 percent of all syphilis cases in 2003, although they account for only 1 percent of the U.S. population.
In addition, the study found that the expanding “recreational use” of crystal methamphetamine and Viagra is fueling increases in syphilis, H.I.V. and other sexually transmitted diseases among gay and bisexual men.
Crysal Meth, known as “Speed,” heightens sensations of all types, making it a popular drug to take before intercourse. According to researchers, the drug seems to be especially popular among men who engage in unprotected anal sex.
In a study of 388 gay men, Dr. Gordon Mansergh reported that his team from the Centers for Disease Control and Prevention and the San Francisco Health Department found that 16 percent had used crystal methamphetamine the last time they had anal sex. Additionally, the study found that 17.4 percent of 1,263 gay men who had gone to the San Francisco Health Department’s sexually transmitted disease clinic used crystal before.
Crystal users in the study were twice as likely as nonusers to have engaged in unprotected receptive anal intercourse, were more than twice as likely as nonusers to be infected with H.I.V., the virus that causes AIDS, 4.9 times as likely to receive a diagnosis of syphilis and 1.7 times as likely to test positive for gonorrhea.
Dr. William Wong of the San Francisco Health Department said that another study found that gay men who used both crystal and Viagra together were 6.1 times as likely to receive a diagnosis of syphilis as those who did not use either drug.
"We are very, very concerned" about the trend, Dr. Ronald O. Valdiserri, an official of the Centers for Disease Control and Prevention, said at a news conference at the meeting.
Health officials from Seattle also reported a sharp increase among gay men in cases of gonorrhea that is resistant to a commonly prescribed antibiotic, ciprofloxacin.
From October 2003 through December 2003, ciprofloxacin-resistant gonorrhea accounted for 22 of 133 cases, or 16.5 percent, compared with 6 of 159 cases, or 3.8 percent, from July through September 2003. The overwhelming majority of drug-resistant gonorrhea was among gay men. Such drug-resistant gonorrhea has also being reported in Boston and New York.
AIDS, meanwhile, remains the greatest threat of all the sexually transmitted diseases. Researchers can't easily track the rate of new HIV infections because many people don't get diagnosed for years. However, federal statistics released last fall revealed that infection rates among gay and bisexual men in 29 states grew by 17 percent from 1999 to 2002.
Los Angeles County health officials reported new evidence from two studies that the Internet and commercial sex clubs helped increase syphilis rates among gay men. One study found that 22 percent of those who received a diagnosis of syphilis had met sexual partners on the Internet about the time they were most likely infected. A second study found that 28 percent of gay men with syphilis met sex partners at commercial sex clubs.