Report on Syphilis Reinforces Concern About Sex Practices

A federal report released Thursday on a syphilis outbreak in Southern California last year underscores fears that gay and bisexual men’s participation in risky sexual practices has increased. More alarming, Centers for Disease Control researchers said, was the finding that at least 34 gay or bisexual men who were part of the 130-case outbreak in Los Angeles, Orange, Riverside and San Diego counties were aware that they had HIV.

The findings were consistent with other studies in Los Angeles and nationwide, suggesting that a subset of the gay and bisexual population is engaging in condomless sex, sometimes with multiple partners, even when the men know they could transmit HIV or other diseases.

Though syphilis has been declining nationally, there are segments of the population that remain at high risk, said Dr. Ronald Valdiserri, deputy director of the CDC’s center for the prevention of HIV, sexually transmitted diseases and tuberculosis.

African Americans continue to be disproportionately affected by syphilis, and infections are increasing among Latinos and in pockets of the gay and bisexual communities, according to the report.

Of the 130 syphilis cases reported between January and July 2000, 66 involved gay or bisexual men.

The report focused on those men and did not provide demographic details about the rest of the 130 people who were infected.

Forty-nine of the gay or bisexual men were from Los Angeles County, 10 from Orange County, six from San Diego County and one from Riverside County.

Four in 10 were white, more than a third were Latino and almost a fifth were African American.

According to the report, the men were involved in a number of unsafe practices, including:

* Sex with unknown partners. Of the 66 infected gay or bisexual men, half said they had had sex with strangers, more than a quarter had met their sex partners in bathhouses and several had had sex with prostitutes or met partners through the Internet.

* Lack of condom use. Just 20% reported using condoms in their most recent sexual encounters.

* Drug use. Illicit drugs were used by 40%, with crystal methamphetamine used most frequently.

Availability of increasingly effective drug therapies for AIDS patients may be causing a lack of concern about safe sex, health officials said.

“The message of safer sex as a whole is not being heeded,” said Michael Weinstein, president of the AIDS Healthcare Foundation in Los Angeles County. “We’re not doing anything to make it sexier and hip to practice safe sex.”

Improved public health efforts must be made, particularly in promoting condom use, Weinstein said.

However, the report noted that the men in the study had access to medical care.