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The resurgence of syphilis among men who have sex with men

Peterman, Thomas Aa; Furness, Bruce Wa,b

Current Opinion in Infectious Diseases: February 2007 - Volume 20 - Issue 1 - p 54–59
doi: 10.1097/QCO.0b013e32801158cc
Sexually transmitted diseases and urinary tract infections

Purpose of review To identify recent progress and emerging problems in addressing syphilis among men who have sex with men.

Recent findings A resurgence of syphilis has occurred among men who have sex with men in many developed countries. Infection has been associated with HIV coinfection, multiple partners, and recreational drug use. Unlike HIV, oral sex appears to be a common route of syphilis transmission. Many prevention approaches have shown, at best, modest success. Variable clinical presentation and potentially inconclusive lab tests make diagnosis confusing.

Summary As the infection remains relatively rare, clinicians treating men who have sex with men should maintain a high index of suspicion for syphilis lesions, and should screen their sexually active patients for latent disease. Debates about syphilis control and treatment continue. The clinical manifestations, serologic responses, efficacy of treatment, and complications of syphilis have always been complicated. HIV coinfection adds to the confusion.

aDivision of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

bDivision of STD Control, Bureau of Communicable Disease Control, Washington, DC, USA

Correspondence to Thomas A. Peterman, MD, MSc, Mailstop E02, CDC, Atlanta, GA 30333, USA Tel: +1 404 639 6102; fax: +1 404 639 8610; e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.