L.A., S.F. Syphilis Outbreaks Not Followed by Leaps in HIV

Los Angeles and San Francisco have yet to see the sharp rise in HIV rates that health officials have been fearing ever since the two cities had syphilis outbreaks among gay and bisexual men earlier this decade.

Health officials believed the syphilis outbreaks indicated that many gay and bisexual men were abandoning safe-sex practices and that a corresponding surge in HIV cases would soon follow.

But large jumps in HIV cases did not occur. In San Francisco, only 1.9% of gay and bisexual men had the AIDS virus in 1998. Although that rate more than doubled to 3.9% a year later, it had dropped to 2.4% by 2002, the Centers for Disease Control and Prevention said Thursday.

New HIV cases dropped from 4.8% of Los Angeles’ gay and bisexual men in 1998 to 4.1% in 2002, the CDC said.

Other large U.S. cities that have had syphilis outbreaks, including Atlanta; New York; Fort Lauderdale, Fla.; Miami, Houston; and Chicago, also have failed to see HIV rates rise for gay and bisexual men, said Dr. Scott Holmberg, an epidemiologist with the CDC’s Division of HIV and AIDS Prevention.

The CDC explained the findings by saying that only a small number of people overall were infected with syphilis and that in San Francisco and Los Angeles, about 60% of the men newly infected with syphilis already had HIV.

But the government warned that if the syphilis outbreaks continued, health officials still could see a rise in HIV among gay and bisexual men.

“We will continue to monitor the situation closely,” Holmberg said.

Syphilis cases jumped among gay and bisexual men in San Francisco from just four in 1998 to 260 in 2002. In Los Angeles, health officials treated 67 new cases of syphilis in 2000. That number reached 299 in 2002.