ATLANTA
—
Patricia
Hawkins
remembers
attending
the
funeral
of
10
friends
who
died
from
complications
related
to
AIDS
in
the
span
of
14
days
during
the
early
years
of
the
epidemic.
She
remembers
the
disbelief
and
horror
she
and
many
other
lesbians
and
gay
men
experienced
as
they
witnessed
seemingly
healthy
young
gay
men
waste
away
before
their
eyes
within
a
matter
of
weeks,
and
then
die.
But
today,
Hawkins,
associate
executive
director
of
the
Whitman-Walker
Clinic
in
Washington,
D.C.,
fears
too
many
young
gay
men
do
not
remember
the
days
when
HIV
was
an
automatic
death
sentence,
and
have
reverted
to
having
unsafe
sex
that
leaves
them
susceptible
to
contracting
a
host
of
sexually
transmitted
diseases.
More
fuel
was
added
to
Hawkins’
burning
concern
on
Monday
when
the
Centers
for
Disease
Control
&
Prevention
released
its
2003
STD
Surveillance
Data
showing
that
gay
and
bisexual
men
continue
to
be
responsible
for
rising
syphilis
rates
in
the
U.S.
The
national
syphilis
rate
was
at
an
all-time
low
in
2000,
but
increased
for
the
third
straight
year
in
2003
to
2.5
cases
of
primary
and
secondary
syphilis
per
100,000
people,
a
4.2
percent
increase
from
the
2002
rate,
according
to
the
CDC.
The
CDC
estimates
that
more
than
60
percent
of
the
primary
and
secondary
syphilis
cases
reported
in
2003
were
found
in
men
who
have
sex
with
men,
and
syphilis
cases
among
all
men
have
skyrocketed
68
percent
in
the
last
three
years.
“When
you
have
syphilis
rates
go
up
68
percent
among
[men]
across
the
country,
that
is
an
indicator
people
are
not
practicing
safer
sex
as
they
were
years
ago,”
Hawkins
said.
“I
think
we
have
to
acknowledge
that
we’ve
had
a
significant
increase
in
[high-risk
sexual
behavior]
in
our
community
and
that’s
what
is
being
born
out
in
this
data.”
San
Francisco
topped
the
list
of
cities
with
the
highest
rate
of
reported
syphilis
cases
per
100,000
people
in
2003,
with
43.5.
Some
332
cases
were
reported
last
year.
Atlanta
saw
a
16.1
percent
increase
from
its
2002
syphilis
rate,
ranking
No.
2
on
the
2003
list,
with
298
cases
reported
and
a
rate
of
36.1
per
100,000
people.
Baltimore’s
syphilis
rate
grew
by
27
percent
in
2003,
when
the
city
reported
153
cases,
which
ranked
it
third
on
the
CDC
list.
Its
rate
per
100,000
people
is
24.
“The
gay
and
bisexual
men’s
community
has
been
dealing
with
HIV
and
AIDS
for
decades
now,
and
there
is
some
complacency
in
the
community
around
that,”
said
Jason
Riggs,
communications
director
for
the
Stop
AIDS
Project
in
San
Francisco.
“People
need
to
make
informed
decisions,
be
honest
about
their
behavior
with
themselves
and
what
is
needed
now
more
than
ever
is
a
community
engagement
that
goes
beyond
the
public
health
organizations,”
he
added.
Safe-sex
messages
must
again
be
sounded
from
places
outside
of
community-based
clinics,
including
in
gay
bars
and
other
social
venues
for
gay
men,
Riggs
said.
The
uptick
in
reported
syphilis
infections
in
San
Francisco
have
mainly
been
among
HIV-positive
men,
which
causes
health
experts
to
worry
that
a
similar
HIV
outbreak
would
soon
follow,
Riggs
said.
But
evidence
suggests
that
some
HIV-positive
men
are
“sero-sorting,”
or
only
having
sex
with
other
HIV-positive
men,
which
may
explain
why
a
dramatic
HIV
outbreak
hasn’t
recently
occurred
in
San
Francisco,
Riggs
said.
Syphilis,
which
can
easily
be
cured
by
penicillin
in
its
early
stages,
is
transmitted
through
often
unnoticeable
sores
during
oral,
anal
and
vaginal
sex.
If
untreated,
the
infection
could
damage
internal
organs
including
the
brain,
nerves,
eyes,
heart,
blood
vessels,
liver,
bones
and
joints,
according
to
the
CDC.
In
1999,
the
CDC
launched
its
National
Plan
to
Eliminate
Syphilis
from
the
United
States,
but
its
efforts
focused
mainly
on
preventing
the
spread
of
the
disease
among
African-American
females,
who
at
the
time
accounted
for
most
syphilis
cases,
said
Ron
Valdiserri,
deputy
director
of
the
CDC’s
National
Center
for
HIV,
STD
&
TB
Prevention.
After
experiencing
success
with
reducing
syphilis
among
black
females,
whose
rate
decreased
33.3
percent
from
2002
to
2003,
Valdiserri
said
the
CDC
is
now
working
with
local
health
agencies
to
target
gay
and
bisexual
men.
Plans
include
using
the
Internet
to
deliver
safe-sex
messages,
and
addressing
the
“very
dangerous
synergy
between
crystal
meth
use
and
outbreaks
of
syphilis,”
he
said.
The
CDC
also
issued
sobering
news
about
gonorrhea
among
gay
and
bisexual
men
earlier
this
week.
Although
the
national
rate
of
gonorrhea
dropped
to
an
all-time
low
of
116.2
cases
per
100,000
people
in
2003,
CDC
expressed
concern
about
increases
in
drug-resistant
strains
developing
in
gay
and
bisexual
men.
Gonorrhea,
whose
symptoms
can
include
a
burning
sensation
when
urinating,
or
a
white,
yellow,
or
green
discharge
from
the
penis,
is
usually
cured
with
antibiotics.
But
one
antibiotic,
fluoroquinolones,
is
becoming
increasingly
obsolete
for
gay
and
bisexual
men,
Valdiserri
said.
“We
can’t
develop
one
antibiotic
and
use
it
forever
and
ever
because
for
the
most
part
these
germs
will
evolve
to
the
point
where
it
is
resistant,”
Valdiserri
said.
In
April,
the
CDC
said
increased
resistance
to
fluoroquinolones
meant
it
should
no
longer
be
used
to
treat
gay
and
bisexual
men,
he
said.
The
problem
is
that
the
only
remaining
antibiotics
for
gonorrhea
are
injectable,
which
can
sometimes
dissuade
individuals
from
seeking
treatment,
Valdiserri
said.
If
left
untreated,
gonorrhea
can
cause
pelvic
inflammatory
disease
in
women
and
cause
...