Sexually Transmitted Diseases  >  Tracking the Hidden Epidemics 2000 (1999 data)

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A Closer Look at Syphilis

BY GENDER

In 1999, the overall male-to-female ratio of P&S syphilis was 1.5, with 50 percent more cases among men than women. Increases in the male-to-female rate ratio in 1999 were observed in certain cities corresponding to an increase in syphilis among men who have sex with men (MSM). Recently, outbreaks of syphilis among MSM have been reported, possibly reflecting an increase in risk behavior in this population associated with the availability of highly active antiretroviral therapy for HIV infection.

BY RACE/ETHNICITY

Syphilis continues to disproportionately affect African Americans. Syphilis has been cited as one of the most glaring examples of existing gaps in minority health status. Despite the fact that the disease can be easily treated and cured with basic medical care, reported rates of P&S syphilis are 30 times higher for African Americans than for white Americans (CDC, 2000). With increased awareness and access to acceptable health care, this health disparity could be largely eliminated.

From 1997 to 1999, rates of p&s syphilis were stable for white Americans, declined 29 percent in African Americans and increased 20 percent in Hispanics. The increase in Hispanic rates occurred among males.

In 1999, the rate of congenital syphilis among African Americans was 57.9 cases per 100,000 live births and among Hispanics, 20.4 cases per 100,000 live births. While these rates reflect a 52.7 percent decline for African Americans and a 38.9 percent decline for Hispanics from 1997 to 1999, they remain considerably higher than the rate for whites, which was two cases per 100,000 live births.

BY AGE

P&S syphilis rates in 1999 were highest among women ages 20 to 29 years old and among men ages 35 to 39 years old. However, the age groups at highest risk vary by race and ethnicity.

BY REGION

Syphilis continues to be concentrated in the southern region of the United States. In 1999, the rate of syphilis in the south-4.5 cases per 100,000 people-was higher than any other region in the country. In 1999, three independent cities-Baltimore, Md.; Danville, Va.; and St. Louis, Mo.-and 22 counties accounted for half of the total number of P&S syphilis cases reported.

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