Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
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Washington Blade - April 11, 2003
Joe Crea
Howard Sommers, acting director of the sexually transmitted disease division of the Broward County Health Department, said that up to 90 percent of all accounted syphilis cases were reported by men and 85 percent of those men are co-infected with HIV.
"We're talking about a syphilis infection raising viral loads among men who are infected with HIV," Sommers said. "When you have HIV, you don't want to put any additional stress on the immune system."
Sommers said that Broward County has seen a significant increase in syphilis infections during the past three years. In 1998, there were 13 reported cases of syphilis for the entire year. Currently, 11 new cases are reported each month, Sommers said.
"This is a result of high-risk activity and not all gay men engage in this type of behavior," Sommers said. "Since a lot of these cases are being reported by men who are HIV-positive, a lot of them are not as worried about getting something else. This is a group of people who are engaging in high-risk behavior and infecting people who might not traditionally have high-risk partners."
Lorri Jordahl, Miami-Dade's STD program consultant, said that many gay men have suffered from "message fatigue," noting that "condom only" messages fail to have the same impact they once did in the late '80s.
Jordahl also noted that a minority of men infected with syphilis who visit her office simply get their medicine and go back out on the prowl.
"We call them 'frequent fliers,'" Jordahl said. "They come in, get tested, get their antibiotics and go out and do the same exact thing."
Hardnett said that each person who tests positive for syphilis is interviewed by a disease intervention specialist. Those who test positive may opt to provide the specialist with the names and phone numbers of their most recent sexual contacts. Hardnett said these individuals are then free to suggest friends who may have been exposed to syphilis.
"We classify the sexual partners as 'partners' and the friends as 'suspects'," Hardnett said. "As a result, we approach [friends] differently. We contact these individuals and let them know that someone who cares about your health is worried that you might have been exposed to syphilis or HIV and we wanted to offer you an anonymous or confidential test."
To tackle the growing problem, Hardnett's team at the Miami-Dade Health Department produced three ads targeting gays in the area. One features a man with syphilis ulcers on his tongue and lower lip with the text, "Got Syphilis!" below the image.
"The 'gross out' factor really got people talking about oral sex," Jordahl said. "People aren't as concerned about getting a disease through oral sex."
Syphilis is a sexually transmitted infection caused by bacteria that land on the body -- usually on the penis or anus -- during sex with an infected partner. Within 90 days of infection, a red, painless ulcer appears on the site where the infection took place and heals within a few weeks. But at that time, the bacteria enters the body causing fever, joint pain, fatigue, liver problems, enlarged lymph nodes, eye problems and a copper-colored skin rash that appears on palms and soles.
Joe Crea can be reached at jcrea@washblade.com.
FOR MORE INFO Broward County Health Dept. 2421-A SW 6th Ave. Fort Lauderdale, FL 33315 www.browardchd.org
Miami-Dade County Health Dept. 8175 NW 12 St. Miami, Florida 33126 305-324-2400 www.dadehealth.org
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