Washington Blade - May 25, 2007
Elizabeth Perry

A new campaign running through June 3 is targeting gay and bisexual men statewide and stresses the importance of testing, education and prevention to reduce syphilis rates. The campaign includes ads displayed in 125 Northern Virginia buses, cable television ads, public service announcements, posters and a hotline number (1-800-533-4148).

"The phones haven't rung this much since Magic Johnson was diagnosed with HIV," said Dr. Robert Johnson, director of Outbreak Response, Division of Disease Prevention at the Virginia Department of Health. "It means the campaign is working. The hotline will direct them where to go, how to recognize the symptoms and identify the risk factors."

The Washington Post reported Virginia had documented 352 cases in 2006, a 31 percent increase from 2004. In the first three months of this year, there was a 39 percent jump. Johnson said Alexandria, Arlington, Fairfax, Richmond, Norfolk, Hampton Beach and Virginia Beach accounted for 89 percent of syphilis cases reported in Virginia in 2006.

Syphilis, a sexually transmitted bacterial disease, is transmitted through the same unsafe sex practices as HIV/AIDS. Unlike HIV, syphilis is not infectious all the time and is harder to transmit, according to Johnson. He said the disease is passed through contact with an open syphilis sore. Condoms can prevent the transmission of HIV, gonorrhea and chlamydia, but they only prevent the transmission of syphilis if the infected lesion is covered.

"It can only be transmitted when a lesion appears on the site of sexual contact," he said.

Dr. B.W. Furness, a physician who volunteers at the Gay Men's Health and Wellness Clinic at Whitman-Walker Clinic, said during the first stage of the disease, sores appear and may last three to six weeks before going away by themselves. The second stage is marked by a rash that most often appears on the palms and soles of the infected person and goes away without treatment.

The third stage is more insidious because it has no symptoms and can last for years while it destroys the infected person from within. The final stage is characterized by damage to the brain, nerves, eyes, blood vessels, liver, bones and joints. In its early stages the disease is easy to detect and treat with a blood test and a shot of penicillin.

Johnson said the rising number of cases among gay and bisexual men in Virginia mirrors a national trend that began in urban areas in San Francisco and other Western cities six years ago and spread across the country to New York and Washington. In 2001 in Virginia, a demographic shift began from an equal number of cases between males and females to more males.

"We were talking about eliminating it in 2003 in Virginia," Johnson said. "We started to see a shift and started doing something about it. We worked with the D.C. and Maryland health departments to do outreach, targeting sex clubs and bars."

Furness said national numbers on syphilis date back to 1941. Prior to 1999, most of the cases reported were seen in black men in the rural South. The late '90s showed a marked decrease in cases and the disease was at its lowest recorded level in 2000.

"The same practices that were working to reduce HIV were working for syphilis," he said. "Safe-sex practices and condom use. Once HIV hit, you had fear and education on your side. We saw decreases in all sexually transmitted diseases."

The latest CDC figures show the highest rates of transmission in men in their 20s and 30s. Furness said the increase in syphilis rates could be due to a number of reasons, including crystal meth use and "sero-sorting," where men of like HIV status hook up and do not practice safe sex.

He said the higher rates among older men who came of age during the AIDS epidemic of the 1980s could be due to survivor burnout.

"Those who survived and didn't become infected with HIV years ago are tired of hearing the messages about safe sex," he said.

Among younger men, Furness said higher infection rates could be attributed to a lack of information about HIV/AIDS and syphilis. He said young gay adolescents can't relate to heterosexual sex education classes and they do not know where to go for information.

"Gays are coming out earlier," he said. "Young adolescents and young adults are becoming sexually active without any kind of education."

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