CALIFORNIA: Rise in Syphilis in San Francisco Tied to Internet

Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.

CALIFORNIA: Rise in Syphilis in San Francisco Tied to Internet

Reuters Health (12.18.03) - Friday, December 19, 2003

The Internet is a major factor in San Francisco's increase in early syphilis infections among men who have sex with men (MSM), according to a new CDC report. However, the Internet can also be used to track and treat the STD, the authors wrote.

A summer 1999 outbreak of early syphilis among MSM who met their partners on the Internet "presaged a rapidly expanding syphilis epidemic in San Francisco." By 2002, the city reported the highest rates of first- and second-stage syphilis of any metropolitan area in the nation.

Between 1998-2002, early syphilis cases rapidly increased from 41 to 495. Officials noted at the time the proportion of cases among MSM had jumped, from 22 percent in 1998 to 88 percent in 2002.

A focus on data for 415 MSM diagnosed with early syphilis in 2002 found that Internet chat rooms were the most common venues for meeting partners. Chat rooms were used more often for this purpose than bars, bathhouses or sex clubs. Among 151 MSM interviewed, nearly 45 percent reported meeting sex partners online, and about one-fifth had no other contact information for the partner except for an e-mail address.

"As the association between syphilis among MSM and the use of the Internet as a means for meeting sex partners grows, health departments must adopt new strategies for partner notification," said CDC and San Francisco Department of Public Health officials. They have evidence that Internet-based partner notification can be an effective tool for finding and treating early syphilis infections.

"Local health departments in other cities that have had large increases in early syphilis cases among MSM should consider using the Internet for partner notification and management," the authors of the report wrote. San Francisco's DPH developed interim online notification guidelines that address "concerns about protecting confidentiality and ensuring that messages are not discarded as junk e-mail, two common barriers to online partner notification."

The full article, "Internet Use and Early Syphilis Infection Among Men Who Have Sex with Men - San Francisco, California, 1999-2003," appeared in Friday's Morbidity and Mortality Weekly Report (2003;52(50):1229-1232).
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