Fighting the current epidemic requires intensive education of clinicians and men who have sex with men, as well as targeted screening
A research article (page 179)1 and a letter to the editor (page 218)2 in this issue of the Journal should leave you in no doubt that syphilis is back. After falling precipitously with the onset of the HIV epidemic in the early 1980s, syphilis infection rates are rising dramatically in Australia and the developed world among men who have sex with men.3 Why has this occurred, and what can be done about it?
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- 1 University of Melbourne, Melbourne, VIC.
- 2 The Centre Clinics, Victorian AIDS Council, Gay Men's Health, Melbourne, VIC.
- 1. Jin F, Prestage GP, Kippax SC, et al. Epidemic syphilis among homosexually active men in Sydney. Med J Aust 2005; 183: 179-183. <MJA full text>
- 2. Guy RJ, Leslie DE, Simpson K, et al. Sustained increase in infectious syphilis notification in Victoria. Med J Aust 2005; 183: 218. <MJA full text>
- 3. Fenton KA, Nicoll A, Kinghorn G. Resurgence of syphilis in England: time for more radical and nationally coordinated approaches [see comment]. Sex Trans Inf 2001; 77: 309-310.
- 4. Health Protection Agency. Epidemiological data on syphilis [updated 2004 November 24]. Available at: http://www.hpa.org.uk/infections/topics_az/hiv_and_sti/sti-syphilis/epidemiology/epidemiology.htm (accessed Jul 2005).
- 5. Fairley CK, Bowden FJ, Gay NJ, et al. Sexually transmitted diseases in disadvantaged Australian communities. JAMA 1997; 278: 117-118.
- 6. Hull P, Van de Ven P, Prestage G, et al. Gay community periodic survey: Sydney 1996–2002. Sydney: National Centre in HIV Social Research, 2003. Available at: http://nchsr.arts.unsw.edu.au (accessed Jul 2005).
- 7. Imrie J, Stephenson JM, Cowan FM, et al. A cognitive behavioural intervention to reduce sexually transmitted infections among gay men: randomised trial. BMJ 2001; 322: 1451-1456.
- 8. Klausner JD, Levine DK, Kent CK. Internet-based site-specific interventions for syphilis prevention among gay and bisexual men. AIDS Care 2004; 16: 964-970.
- 9. Clinical guidelines for the management of sexually transmissible infections among priority populations. Sydney: Australasian College of Sexual Health Physicians, 2002.
- 10. Lister NA, Smith A, Tabrizi S, et al. Screening for Neisseria gonorrhoea and Chlamydia trachomatis in men who have sex with men (MSM) at male-only saunas. Sex Trans Dis 2003; 30: 886-889.