Syphilis Relapse

Cases soar in the city

But some are finding that their campaigns to fight syphilis and HIV end up at odds. "It's complicated when you're selling a syphilis and an HIV message," says Russell Westacott, associate director of the Institute for Gay Men's Health at the Gay Men's Health Crisis. "There's confusion around how people get syphilis. People think it's only through unprotected sex"—and thus the same risk for HIV. "They rarely consider oral sex or other sexual contact as a risk, even though it is."

While Westacott and others have been advising people who have multiple partners to get tested for syphilis even if they use condoms, that message is taking a while to sink in. "What we sometimes hear in the testing center is that if it's not HIV, I don't need to worry so much about it," says Drew De Los Reyes, assistant director of the David Geffen Center for HIV Prevention and Health Education, also at GMHC.

The availability of new rapid HIV tests, which gives results the same day, also cut into the likelihood that patients will get—and come back to pick up the results from—a syphilis test. "Since we started offering rapid testing, we have seen somewhere between a 40 and 45 percent decline in the number of people testing for syphilis," says De Los Reyes.

illustration: Sam Weber

So those on the front lines are trying to find creative ways to sound the alarm about syphilis's return. The Institute for Gay Men's Health passed out information to beachgoers on Fire Island last summer. The health department has been holding regular "healthy men's nights out," offering free screenings for syphilis and other STDs at bars and other locations in Chelsea and elsewhere. (The next is April 26 at Urge in the East Village.) And doctors who treat STDs are beginning to broach the subject with their patients, male and female alike.

Indeed, though, for now, the majority of new cases are in gay men, experts say others shouldn't consider themselves immune. "These things eventually follow the pattern of getting into the heterosexual population," says Kings County's Augenbraun. "If history teaches us anything, it's that, if we allocate resources for prompt treatment and testing of syphilis, we may be able to see a decline. On the other hand, if we don't, then I guarantee you this disease will move out of this relatively small group into a broad cross-section of New York City."

Sharon Lerner is a senior fellow at the Center for New York City Affairs at New School University.

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