Bay Windows - May 11, 2006
Ethan Jacobs, ejacobs@baywindows.com

Dr. Carol Ciesielski, who was part of the research team behind the Chicago study, presented her findings to press at a briefing during the Jacksonville conference. In response to a rise in syphilis cases among MSM in Chicago Ciesielski said health officials stepped up prevention efforts in the city beginning in 2002, and in both 2003 and 2004 infection rates dropped, yet in 2005 infections among MSM took a sharp upward turn, increasing by 87 percent. She said she and her fellow researchers found that one potential reason for the rise may be repeat infections. Ten percent of all MSM who tested positive between 2000 and 2005 had repeat infections, compared with only one percent of women and 0.5 percent of heterosexual men. She said these MSM who are reinfected may in part be responsible for driving up cases among MSM.

Ciesielski said another challenge to fighting the epidemic among MSM is that more than half the men testing positive for syphilis reported anonymous sex partners, making partner notification efforts more difficult.

Another study of syphilis patients in San Diego found that MSM were about a third less likely than their heterosexual peers to be diagnosed during primary stage syphilis, when the disease is most infectious. Researchers believe the disparity may come in part from the mechanics of sex between men compared with heterosexual sex. MSM who "bottomed" during anal intercourse were less likely to be diagnosed in the early stages than other MSM. Dr. John Douglas, director of the CDC's STD prevention division, said that they may not realize they are infected because the syphilis lesions, which are highly infectious, may go undetected if they are in their anus or mouth.

The study also showed a new partner notification program that researchers hope will reduce syphilis infections among MSM. In 2004 San Francisco launched a partner notification program called inSPOT.org, in which men who test positive for STDs could send e-cards to partners, either under their own name or anonymously, letting them know they may be at risk and giving them information about getting tested. Dr. Deborah Levine at the Internet Sexuality Information Service, which developed the site, told press during the briefing that in 2005 visitors to the site sent 23,745 e-cards to 39,000 recipients, and more than a third of recipients clicked on the link to get information on testing. Levine said in focus groups, men frequently notified their significant others after testing positive, but they often did not inform casual sex partners.

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