Before antibiotics, syphilis was the most feared sexually transmitted disease (STD) out there. It was easy to get, quack cures were ineffective and often unpleasant, and it could lead to blindness, disfigurement, dementia, or even death. When we were finally able to zap infections away with drugs like penicillin, it seemed like we’d finally won the battle against this scourge. Whereas syphilis rates were highest before antibiotics became widespread in the 1940s, by 2000 we saw a low of 2.1 cases of syphilis per 100,000. At the dawn of the new millennium, many scientists thought the United States was at the dawn of the complete elimination of syphilis.

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Using condoms, regular STD testing, and limiting sex partners are the best ways for sexually active people to stay healthy.

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Must all good things come to an end? They shouldn’t have to, but in the case of syphilis, the Centers for Disease Control and Prevention (CDC) has announced that syphilis rates are rising, with incidence doubling since 2005. In the United States, there are now 5.3 cases of syphilis per 100,000 people, but that number is a bit misleading because it represents an average across the general population. When you break the population down by age, race or ethnicity, gender, or sexual orientation, that rate might be much higher or much lower. For example, syphilis rates are actually on the decline among women (at only 0.9 cases per 100,000), but among men it is 9.8 per 100,000. In fact, most new syphilis cases — 91.1 percent of them, to be precise — are in men, most of whom are gay or bisexual.

Syphilis is rising the most dramatically among men in their twenties, especially among men who have sex with men (MSM). While some wonder if syphilis is growing among twenty-somethings because this group didn’t live through the early era of AIDS, when HIV was seen as a death sentence and safer sex practices were more common, it might also be due to the fact that STD rates are higher among young people in general. Continue reading →