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Rise in Sexual Diseases May Signal Return of Unsafe Sex

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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.

The latest gonorrhea statistics only go through 1998, so no one knows what has happened since, Laurence says. Preliminary data from 1999, however, show that the disease may once again be on the decline.

Recent studies have shown that 50% of gay men and 50% of women in high-risk groups use condoms all of the time, and that 20-30% of gay men and high-risk women use condoms often, but not always, Laurence says. High-risk groups mainly include people with multiple sex partners and those who use IV drugs.

"That's still a high number, [but] there are pockets of people in San Francisco, particularly young gay men, who feel that HIV is not in their population," Laurence tells WebMD.

According to Laurence, their attitude is: "'Well, I can practice safe sex for 30 to 40 years, or do exactly what I want, get infected, live 10 to 15 years without any signs or symptoms of the disease, then take protease inhibitors or whatever drug is available at that time. So why should I be celibate or good when I can take risks and the worst thing that can happen is that I shave a few years off my life?'"

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