After static or slightly declining numbers, infections spike 60 percent | After seeing the number of syphilis cases remain stable in 2004 and 2005 then decrease in 2006, the New York City health department is reporting that syphilis cases increased by 60 percent in 2007 over 2006, with that growth due to new infections among gay and bisexual men.
“Whichever way you choose to spotlight it or put your magnifying glass on it, syphilis is increasing in New York City,” said Dr. Susan Blank, assistant commissioner in the department's Bureau of Sexually Transmitted Disease Control.
The health department will report 927 syphilis cases in 2007 compared to 578 cases in 2006. Syphilis cases went from 621 in 2004 to 616 in 2005.
There are limitations on the health department data. In recent years, roughly two thirds of people with syphilis agreed to be interviewed by city health department staff.
“We do try to interview all cases and of the cases that we've interviewed, the majority of those report being men who have sex with men or bisexual,” Blank said.
Ninety-seven percent of the 2007 infections were in men and among those men interviewed, 86 percent were gay or bisexual, according to Blank.
Black men accounted for 31 percent of the cases followed by white and Latino men, both at 24 percent, and then men of unknown or other race or ethnicity at 21 percent. Over half were HIV-positive.
“Of those that we've interviewed, 57 percent reported being HIV co-infected,” Blank said.
Having a sexually transmitted disease (STD), such as syphilis, can make it easier to transmit or acquire HIV, the virus that causes AIDS.
Manhattan had 43 percent of the syphilis cases, followed by Brooklyn at 27 percent, and Queens at 15 percent. The largest increases were in Chelsea, Greenwich Village, Union Square, and Washington Heights, a fact that suggests that the dramatic growth in infections is driven by cases among men living in largely white gay enclaves.
The health department said in July of 2007 that it was seeing a spike in syphilis cases. Asked if the city would likely see more than 1,000 new syphilis cases in 2008, Blank said, “Probably, unfortunately.”
Syphilis cases in the city fell in the '90s from a peak of more 5,000 in 1988. Starting in 1999, the numbers began to climb again as cases among gay and bisexual men increased.
Gay and AIDS groups were disturbed by the increase, but said they had been seeing many syphilis cases among their clients.
“We are seeing a lot of syphilis and it's very, very concerning,” said Dr. Gal Mayer, medical director at the Callen-Lorde Community Health Center. “We're going to have to redouble our prevention and outreach efforts… It's a very sobering reminder that we need to always remain vigilant for STDs among all of our patients, especially men who have sex with men, and we need to continually counsel our patients and inform them of the trends in STDs in their communities.”
The Gay Men's Health Crisis (GMHC) could not say it was seeing an increase, but a spokesman for the AIDS agency said they were “seeing a lot of cases.” GMHC launched its “Syphilis is creeping up” campaign last year to urge gay men to get tested for the bug.
“We are upset and saddened to learn that it has continued to be a problem here in New York and nationally,” said Bill Stackhouse, director of GMHC's Institute for Gay Men's Health.
Stackhouse was also disturbed to first hear about the increase from Gay City News and not from the health department.
“It seems, yet again, part of this thing that is going on lately,” he said. “The health department is not communicating either officially or unofficially with those of us who are doing this work. For us to learn about this in this way is just wrong.”
AIDS and gay groups were angered when the health department eliminated the Office of Lesbian, Gay, Bisexual and Transgender Health. News of the closing came right after Dr. Thomas R. Frieden, the city's health commissioner, abruptly pulled out of a February 8 meeting with groups working with black gay men, a move that also angered community advocates.