Gay men syphilis rates over 100x greater than straight men

From medpagetoday.com

The first state-specific analysis of syphilis among men who have sex with men (MSM) shows they have dramatically higher incidence than men whose only sexual partners are female, the CDC is reporting.

Data from 2015, analyzed with a new methodology, show that the incidence of primary and secondary syphilis among MSM was 309.0 cases per 100,000 people, compared with 2.9 per 100,000 among men who reported sex with women only, according to Alex de Voux, PhD, of the CDC’s epidemic intelligence service, and colleagues at the CDC and Emory University in Atlanta.

The disparity was even more marked when the rate among MSM was compared with the 1.8 cases per 100,000 population seen among women, the researchers reported in the April 7 issue of Morbidity and Mortality Weekly Report.

County-by-county data from the U.S. Census Bureau’s American Community Survey included the number of households with a male head-of-household and a male partner, De Voux and colleagues reported, and that information could be used to estimate the MSM population per county.

For the syphilis analysis, the researchers used data from the 44 states that had information on the sex of partners in at least 70% of reported cases. Those states accounted for 83.4% of all 23,872 reported cases in 2015, De Voux and colleagues reported.

State-specific incidence rates among MSM ranged from 73.1 per 100,000 population in Alaska to 748.3 in North Carolina, the investigators found. Syphilis incidence among MSM was highest in the South and West and four of the five states with the highest rates among MSM — Louisiana, Mississippi, North Carolina, South Carolina, and New Mexico — were in the South.

The overall syphilis among MSM was 167.5 times the rate among women, with state-specific rate ratios ranging from 63.7 in Louisiana to 2,140.3 in Hawaii, De Voux and colleagues reported.

Interestingly, the highest overall syphilis rate in the U.S., seen in 1946, was 70.9 cases per 100,000 population — a rate exceeded by the lowest state-specific rate among MSM in 2015: the 73.1 cases per 100,000 observed in Alaska.

The researchers cautioned that the data are based on 44 states and might not reflect the nation as a whole. Similarly, the estimates rely on the American Community Survey data; under-reporting of same-sex households would skew the outcome.

As well, they noted, the analysis did not include cases in which the sex of partners was unknown and if MSM are less likely than other men to report the sex of their partners, the findings might under-estimate the rate of disease among MSM.

Finally, De Voux and colleagues cautioned, not all cases of syphilis are diagnosed and reported.

New online tool finds providers of HIV Pre-Exposure Prophylaxis (PrEP) in the US

PrEP Locator is a national directory of providers of HIV Pre-Exposure Prophylaxis (PrEP) in the US. PrEP Locator seeks to provide patients access to a national, integrated service including both public and private practice providers. An open source tool, PrEP Locator data and map-based widget are easily accessible via API.

logoThe Locator seeks to serve as a common repository for information regarding providers and clinics that prescribe PrEP. The Locator is an open source tool for those who are managing existing directories to share their resources in a common format, so that patients can access a national, integrated PrEP provider location service that includes both public and private practice PrEP providers. Data will be made accessible with open source tools to facilitate patient access through existing organizational websites and mobile apps.

PrEP Locator is presented by Emory University, in partnership with M•A•C AIDS Fund. The project is led by Dr. Aaron Siegler, Research Assistant Professor of Epidemiology at Emory University’s Rollins School of Public Health. The project is guided by a coalition of partners with expertise in the field of HIV prevention: PleasePrEPMe.org, Greater Than AIDS represented by the Kaiser Family Foundation, National Alliance of State & Territorial AIDS Directors (NASTAD).

Gay men headed for an STD epidemic?

From Slate.com

Earlier this month, Poz magazine’s Benjamin Ryan drew attention to a concerning new study out of Northern California’s health system: Using data gathered from July 2012 through June 2015, researchers found that, among a cohort consisting mostly of same-sex–attracted men on the HIV-prevention regimen PrEP, “quarterly rates of rectal gonorrhea and urethral chlamydia increased steadily and about doubled after one year.” In other words, guys on the fantastically effective pill-a-day Truvada program were avoiding HIV infection—there were no new transmissions for regimen-adherent patients over the study period, in fact—but they seemed to be getting other sexually transmitted diseases relatively often.

Read the full article.

Health Alert – Rates of STD infection still at record high

The Centers for Disease Control and Prevention (CDC) has recently been reporting a record increase in cases of syphilis, chlamydia and gonorrhea—after these diseases had been on the decline for several previous years. HIV infections continue to increase as well, especially among men who have sex with men (MSM).  Even worse, catching both HIV and one or more STDs can lead to particularly rapid and damaging health outcomes.

As a result, health experts across the country (including here at the Pitt Men’s Study) recommend that all sexually active men get a full screening for STD, especially HIV, Gonorrhea, Chlamydia, and Syphilis.

To find testing near you, go to the CDC’s testing locator and enter your zip code to find local free testing. The best way to protect your health is to get tested.

CDC sending out an SOS over soaring rates of STDs

From the New York Daily News

Every year, the Centers for Disease Control and Prevention (CDC) releases an annual report of a national overview of sexually transmitted diseases (STDs).

The report for 2015 was not encouraging at all. In fact, it was quite discouraging as such STDs as chlamydia and gonorrhea were at an all-time high, including higher rates of syphilis.

Sexually transmitted diseases are typically not discussed in polite conversation. But the less they are talked about, the more of a hidden epidemic they are becoming.

We need to realize that anyone who has sex — oral, anal or vaginal intercourse and genital touching — can get an STD. It doesn’t matter whether you are straight, married, single or gay, everyone is at risk.

Read the full article.

STDs at an all-time high in the U.S.

From CBSnews.com

Rates of sexually transmitted diseases in the United States continue to rise, and total combined cases of chlamydia, gonorrhea, and syphilis have reached the highest ever, according to a new report from the Centers for Disease Control and Prevention.

std-at-all-time-high-in-usThe data, released today, shows that in 2015, there were more than 1.5 million cases of chlamydia reported, nearly 400,000 cases of gonorrhea, and nearly 24,000 cases of primary and secondary (P&S) syphilis – the most infectious stages of the disease.

“We have reached a decisive moment for the nation,” Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a statement. “STD rates are rising, and many of the country’s systems for preventing STDs have eroded. We must mobilize, rebuild and expand services – or the human and economic burden will continue to grow.”

Researchers found that from 2014 to 2015, syphilis rates rose 19 percent, gonorrhea rates rose nearly 13 percent, and chlamydia increased by almost 6 percent.

These infections are normally curable with antibiotics – but there is growing concern about drug-resistant strains of gonorrhea that don’t respond to standard treatment.

In many cases, people with STDs continue to go undiagnosed and untreated, putting many at risk for severe health complications, including infertility, chronic pain and increased risk for HIV.

Young people and gay and bisexual men continue to be disproportionately affected by STDs. The data shows that Americans aged 15 to 24 accounted for nearly two-thirds of chlamydia diagnoses and half of gonorrhea diagnoses.

Gay and bisexual men accounted for the majority of new gonorrhea and syphilis cases.

The CDC also said it continues to see “troubling” increases in syphilis among newborns.

The syphilis rate among women increased by more than 27 percent from 2014 to 2015, while congenital syphilis – which occurs when the infection is transmitted from a pregnant woman to her baby – increased by 6 percent.

“The health outcomes of syphilis – miscarriage, stillbirth, blindness or stroke – can be devastating,” said Dr. Gail Bolan, director of CDC’s Division of STD Prevention. “The resurgence of congenital syphilis and the increasing impact of syphilis among gay and bisexual men makes it clear that many Americans are not getting the preventive services they need. Every pregnant woman should be tested for syphilis, and sexually active gay and bisexual men should be tested for syphilis at least once a year.”

To reverse this dangerous trend and stop the spread of STDs, the CDC says health care providers, state and local health departments, and the public all need to play a role.

“We should all learn to talk more openly about STDs – with our partners, parents, and providers,” Bolan said. “People who are sexually active should talk to their medical providers about getting tested and reducing their risk by using condoms or practicing mutual monogamy. It is critical that providers ask about their patients’ sexual history and ensure STD screening is a standard part of medical care.”

Gonorrhea treatment showing signs of failing

From Project Q Atlanta

Federal health officials warned of new signs that gonorrhea is growing resistant to current treatments, a development more troubling for gay men who face a higher risk of the sexually transmitted disease than other populations.

Findings of a new study from Hawaii prompted the Centers for Disease Control & Prevention to raise a warning flag on Wednesday during its 2016 STD Prevention Conference in downtown Atlanta. The findings showed that the current treatment for gonorrhea – a shot of ceftriaxone and an oral dose of azithromycin – was losing its effectiveness in a cluster of infections in Hawaii.

That’s more troubling than data released in July that showed emerging drug resistance and limited treatment options for gay men at a time when infections among them are on the rise, federal officials said during a press conference Wednesday.

“It seems that in the battle between humans and pathogens, gonorrhea is a formidable opponent,” said Jonathan Mermin (photo), director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD & Tuberculosis Prevention.

“We are seeing troubling signs that treatments are failing us. We may be running out of options for treating gonorrhea,” he added.

Gonorrhea is one of the most common sexually transmitted diseases in the country and it impacts gay men more severely than other populations. The CDC has said about 56 percent of gonorrhea cases in the U.S. are among men and of those, 48 percent are estimated to be gay men. Put another way, men who have sex men face a gonorrhea incidence 17 times greater that seen in heterosexual men and nearly 14 times that seen in women, based on the 2014 STD Surveillance Report.

Read the full article.