NEW YORK, Sep 10 (Reuters Health) -- Although the incidence of sexually transmitted diseases (STDs) among gay and bisexual men declined substantially during the early 1980s, a report this week from the Centers for Disease Control and Prevention (CDC) indicates that the STD rate and high-risk behaviors have increased in this group in some cities.
This trend is of "particular concern" because a high proportion of individuals with STDs such as syphilis, gonorrhea and chlamydia, are also infected with HIV, say researchers reporting in the September 10th issue of the CDC's journal Morbidity and Mortality Weekly Report.
The CDC team analyzed STD surveillance data reported to the Public Health Department in King County, Washington, between 1997 and 1999. The county includes the city of Seattle. The researchers also collected data on risk factors such as number of sex partners and sexual orientation.
Starting in late 1997, the number of syphilis cases increased and then appeared to stabilize in the later half of 1998 before increasing again in the first 6 months of 1999, according to the authors.
In particular, they found that the proportion of syphilis cases in gay and bisexual men increased from 21% in 1997 to 85% in 1998 and in 1999.
Many of those infected were also infected with HIV. The researchers report that 48 of 67 gay or bisexual men diagnosed with syphilis between 1997 and June 1999 "had HIV infection and two others were HIV seropositive near the time syphilis was diagnosed."
The number of laboratory-confirmed cases of gonorrhea and chlamydia infections among this demographic group also increased between 1997 and June 1999.
According to the CDC experts, individuals with STDs have a 2- to 5-fold increased risk for HIV infection, and STD control is a key component of HIV prevention programs. Therefore, a resurgence of bacterial STDs threatens the effectiveness of HIV prevention efforts in the US.
"Reasons for the increasing rates of bacterial STD in (gay and bisexual men) in King County are unknown," they say. However, the CDC officials speculate that an increased frequency of unprotected sex and other high-risk behaviors may explain these new statistics.
The researchers conclude that more needs to be done to educate gay and bisexual men about preventing STD infections, and recommend that STD surveillance continues "even after rates have decreased in a community."
