Mar 21, 2008  |  By: RYAN LEE  | COMMENTS     

ATLANTA — After reaching its deathbed at the turn of the century, syphilis is once again a “significant burden” in the U.S., with gay and bisexual men making up the majority of domestic syphilis cases, according to the Centers for Disease Control & Prevention.

In 1999, the CDC announced that only 6,657 cases of syphilis were reported in the U.S. — the lowest rate ever. Also in 1999, the CDC unveiled its “National Plan to Eliminate Syphilis,” which mainly focused on curbing the disease among heterosexual females.

During the eight years of CDC’s syphilis elimination project, gay and bisexual men experienced a spike in syphilis rates, and “largely account” for the STD’s national resurgence during that time. At the 2008 National STD Prevention conference last week, CDC officials said the number of syphilis cases remains low — just over 11,000 — but have increased for the seventh consecutive year.

Primary and secondary cases of syphilis increased 16 percent from 2006 to 2007, with an estimated 60 percent of cases occurring among gay and bisexual men. Gay and bisexual men comprised only 5 percent of syphilis cases in 1999.

The CDC hopes to stimulate awareness of syphilis among gay and bisexual men and urges those men to get tested for STDs at least annually, but the agency has had limited success making sure its messages reach the population most at risk for STDs and HIV/AIDS. Last summer, the CDC announced that only 20 percent of all gay and bisexual men ever came in contact with a CDC-sponsored HIV prevention intervention.

“CDC is starting to believe that as we move forward with an integrated platform for prevention, that we need to really have a strengthening of our preventive services to interact with men at all points — where they live, work and play,” Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention, said last week.

“It means partnering more effectively with our community-based organizations to do some of this outreach work,” said Fenton, who is gay. “It means going into venues where we can actually find high populations of men who have sex with men, for example, circuit parties, bathhouses.”

The CDC’s funding structure is one of the reasons it struggles to disperse safer sex messages to broad segments of gay and bisexual men, said Bill Stackhouse, director of the Institute for Gay Men’s Health at the Gay Men’s Health Crisis in New York.

“The CDC and other government funding sources have established a protocol where they are primarily funding interventions that reach individuals and groups — they are not funding enough … large scale attempts to reach people at the community level,” Stackhouse said.

On Wednesday, GMHC launched a new social marketing campaign called “I Love My Boo” that features the tagline “Safer sex is one way we show our love.”  The images target young black and Latino gay and bisexual men, but are on display on telephone kiosks in diverse neighborhoods throughout New York City.

“It’s a public setting, and the message is not only to the young men themselves, but it also is aimed at the wider community,” said Stackhouse, who noted that the month-long campaign is funded by the state health department.

The only HIV/AIDS prevention messages approved by CDC are known as DEBIs, or the Diffusion of Effective Behavioral Interventions. Many of the DEBIs are structured in a way that delivers the prevention message only to people participating in a small group, usually facilitated by a community-based AIDS organization.

The CDC must move beyond targeting gay men at community organizations, bars, and sex venues, and begin investing in campaigns that have the potential to reach gay people wherever they are, Stackhouse said.

“Until we do that, we’re never going to reach [substantial numbers of gay and bisexual men],” Stackhouse said.

So few gay and bisexual men coming in contact with CDC messages is evidence that the agency “probably is not targeting, not funding, and not partnering in the appropriate ways,” said Jason Riggs, deputy director of the Stop AIDS project in San Francisco.

Much of the CDC’s interaction with and understanding of gay men comes from a handful of venues often used to collect data.

“The largest source of CDC data on [gay and bisexual men], the National HIV Behavioral Surveillance System, recruits participants from bars, street locations, dance clubs, cafes/retail stores, Gay Pride events, ...