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Rise in Sexual Diseases May Signal Return of Unsafe Sex


WebMD Health News

June 29, 2000 -- Public officials are concerned that people who are at high risk of contracting sexually transmitted diseases (STDs) may think that the need for safe sex is over.

Recent data showing that the incidence of gonorrhea increased in 1998 after 12 years of decline, along with reports of a syphilis outbreak among gay men in Los Angeles, are prompting these experts to ask why this is occurring and what can be done to prevent forestall the trend.

Some experts suggest that people are abandoning the safe-sex practices they adopted to prevent AIDS transmission because there are now drugs available that make AIDS seem less fearsome. With this in mind, what's needed now is more aggressive awareness campaigns aimed at encouraging condom use, they say.

Gonorrhea causes a variety of conditions, including pelvic inflammatory disease, infertility, and ectopic pregnancy. The infection also makes it easier to transmit HIV, the virus that causes AIDs. Syphilis is a bacterial infection transmitted through vaginal, anal, and oral sex. It is marked by painless red/brown sores on the mouth, genitals, breasts, and hands, followed by a rash and flu-like symptoms. If not treated, syphilis can cause heart disease, brain damage, blindness, and potentially death.

Published in a recent issue of the Morbidity and Mortality Weekly Report, the new data show that gonorrhea rates increased 9% nationwide from 1997 to 1998. From 1985 to 1997, gonorrhea rates had declined by 64.2%, the report shows.

Overall, Midwestern states had a 16.4% increase in gonorrhea cases, while cases in the South increased by 8.7% and cases in the West rose by 6.5%. Only the Northeast states showed a decline, the report found. Mississippi had the highest gonorrhea rate, with 391.5 cases per 100,000 people, and Maine the lowest, with 5.4 cases per 100,000 people.

From January through late March of this year, 93 syphilis cases were reported in Los Angeles. Of these cases, 53 people were also HIV-positive. Typically, there are only 100 syphilis cases reported in the city per year.

Gonorrhea study author Debra Mosure, PhD, an epidemiologist in the division of sexually transmitted disease prevention at the CDC in Atlanta, says that at least part of the increase in gonorrhea rates is due to improved access to care, better reporting, and a switch to more sensitive screening tests.

"Unfortunately, there is a real increase in some populations, particularly among gay and bisexual men, which is possibly due to an increase in unsafe sex" because of the availability of more effective AIDs drugs, she says.

"We need to continue to strengthen our efforts to prevent STDs among certain subpopulations," she says.

The increase in gonorrhea rates and the reported return of syphilis is a problem, says Jeffrey Laurence, MD, a consultant for the American Foundation for AIDS Research and an associate professor of medicine at the New York Hospital-Cornell Medical Center. He says there is a tendency to lapse into earlier habits, especially among young gay men.

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