Primary and secondary syphilis among black and Hispanic men who have sex with men: case report data from 27 States

Abstract

Background: Until 2005, national-level data on the sex of sex partners that describe how primary and secondary syphilis affects men who have sex with men (MSM) of different races or ethnicities were not reported.

Objective: To present data from 27 states comparing trends in primary and secondary syphilis among MSM of different races or ethnicities.

Design: Review of case report data and regression analysis.

Setting: Federal database of case reports in the National Electronic Telecommunications System for Surveillance.

Participants: Men reported to be MSM.

Measurements: Cases of primary and secondary syphilis per 100 000 males of matching race or ethnicity ("rates"), determined by using population data from the National Center for Health Statistics as the denominator to compare age and racial and ethnic differences.

Results: For each year during 2005 to 2008, 27 states from all U.S. census regions reported data on the sex of sex partners for 70% or more of male cases of primary and secondary syphilis. Regression analysis revealed significantly different trends in rates of primary and secondary syphilis: Absolute increases in rates among black MSM and Hispanic MSM were, respectively, 8.0 times and 2.4 times the absolute increase in rate among white MSM. By region, rates among MSM increased 30% in the Midwest, 48% in the South, 73% in the Northeast, and 77% in the West. By age group, the largest absolute increase in rates occurred among MSM aged 20 to 29 years.

Limitation: Results from 27 states may not be generalizable to the United States as a whole.

Conclusion: Rates of primary and secondary syphilis disproportionately increased among black and Hispanic MSM (compared with white MSM) and among young MSM. Care providers should offer counseling about safer sexual practices and screening for syphilis and other sexually transmitted infections when caring for MSM.

Primary funding source: Centers for Disease Control and Prevention.