As syphilis rates increase in Los Angeles County, new study suggests the disease is increasing HIV rates

The syphilis epidemic among men who have sex with men in Los Angeles County may be contributing to rates of HIV in this population, according to a new report published in the Journal of Acquired Immune Deficiency Syndrome.

The authors of the report analyzed specimens banked from men with early syphilis, from the Los Angeles County Public Health Laboratory. Using advanced statistical analysis, the researchers concluded that the annualized HIV incidence was 17% among all men with early syphilis. Among the subgroup of men who have sex with men with early syphilis, the annualized HIV incidence was even higher at 26%.

These results suggest a high rate of HIV acquisition among MSM with early syphilis, and raise strong public health concerns, given the many urban areas in the United States with increased syphilis rates among communities of MSM at risk for or affected by HIV infection.

“We believe this study clearly demonstrates that men are getting infected with HIV and syphilis at the same time underscores the need for integrated HIV and syphilis prevention,” said Peter Kerndt, M.D., M.P.H., Director of the STD Program and a co-author of the study. Syphilis is a disease transmitted through sores, usually in the course of unprotected sex. In its early stages, syphilis can be easily treated with penicillin.

According to the Centers for Disease Control and Prevention, the reported number of HIV infections increased in 29 states from 1999 to 2002, including a 17% increase among MSM. This trend suggests a possible resurgence of HIV transmission in this at-risk population. Moreover, the syphilis epidemic which Los Angeles County has been experiencing since early 2002 remains unabated. In 2004, approximately two-thirds of the more than 800 syphilis cases reported in Los Angeles County occurred among MSM; almost two-thirds of MSM with syphilis had also been infected with HIV.

“The suggestive evidence that syphilis is exacerbating the HIV epidemic among men who have sex with men reinforces the importance of stressing safer sex practices, as well as continuing efforts for the early identification and treatment of syphilis and HIV,” said Jonathan Fielding, M.D., M.P.H., Director of Public Health and County Health Officer.

The high rate of syphilis and HIV co-infection among MSM underscores the ongoing importance of public health efforts on several fronts: integrated HIV/STD testing that is easily accessible, and heightened disease surveillance to monitor trends in syphilis and HIV.

Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, Public Health oversees environmental health, disease control, and community and family health.