Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e3181ffa7b0
Original Study

Infectious Syphilis Among Adolescent and Young Adult Men: Implications for Human Immunodeficiency Virus Transmission and Public Health Interventions

Brewer, Toye H. MD*†; Schillinger, Julie MD, MSc†‡; Lewis, Felicia M. T. MD†§; Blank, Susan MD, MPH†‡; Pathela, Preeti PhD‡; Jordahl, Lori MBA-HA¶; Schmitt, Karla MPH, PhD*; Peterman, Thomas A. MD, MSc†

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Background: In 2008, an increase in syphilis among young black men was noted in New York City (NYC), Miami-Fort Lauderdale, and Philadelphia. To explore this trend, we examined infectious syphilis cases from 2000 to 2008 among adolescent and young adult men in these areas.

Methods: Descriptive analysis of male infectious syphilis cases reported to public health authorities in NYC, FL, and Philadelphia.

Results: From 2000 to 2008, infectious syphilis cases among males increased in NYC (107–1027 cases), Miami-Fort Lauderdale (109–374), and Philadelphia (41–142). This increase was largely attributable to cases among men who have sex with men. Rates among black adolescent males (15–19 years) increased in NYC ([2.6–43.0]/100,000), Miami-Fort Lauderdale ([5.5–48.1]/100,000), and Philadelphia (]8.3–40.3]/100,000). Among males with infectious syphilis in 2008 in NYC, 9.1% of blacks and 6.6% of Hispanics were adolescents compared with 1.6% of whites (P < 0.001). In Miami-Fort Lauderdale, 12.2% of black males were adolescents compared to 2.0% of whites (P < 0.01) and 2.7% of Hispanics (P < 0.01). Black males dominated all age groups in Philadelphia, but were more likely to be <25 years of age than whites (P = 0.02). Human immunodeficiency virus coinfection rates were 14.8% among adolescent males in NYC, 15.4% in Philadelphia, and 25.0% in Miami-Fort Lauderdale.

Conclusions: Very young black males have emerged as a risk group for syphilis in these 3 areas, as have young Hispanic males in NYC. Many are men who have sex with men and some are already human immunodeficiency virus-infected. Targeted risk reduction interventions for these populations are critical.

© Copyright 2011 American Sexually Transmitted Diseases Association


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