Better HIV Prevention Could Be Leading to Higher Syphilis Rates

Syphilis rates increased by 13 percent between 2012 and 2013

Dennis Kunkel Microscopy, Inc./Visuals Unlimited/Corbis

If you think of syphilis as a historic disease, you’re not alone—the prevalance of the sexually-transmitted infection fell dramatically with the introduction of penicillin in the 1940s. But new data shows that the condition is rising dramatically…and its prevalence could be related to our increased ability to prevent HIV.

New data released by the Centers for Disease Control and Prevention shows that syphilis is at its highest rate since 1996. Even more concerning is a sharp uptick in syphilis between 2012 and 2013, with a 13.1 percent spike in cases of all stages of syphilis in just one year. But officials are having a hard time figuring out just what’s behind the increase in cases, reports Daniel Denvir for CityLab.

One “obvious culprit,” says Denvir, is a decline in condom use among gay men. With the CDC data showing that many men who contract syphilis are also HIV-positive, Denvir reports, it could be that the practice of HIV-positive men choosing to have unprotected sex with one another is leading to higher syphilis rates.

But that’s not the entire story. Denvir reports that the availability of PrEP (pre-exposure prophylaxis) drugs that prevent HIV in high-risk individuals could be to blame. Michael Weinstein of the AIDS Healthcare Foundation tells Denvir that by promoting PrEP drugs like Truvada, the CDC and other organizations could be sending the message that condom use isnt necessary:

Weinstein and his critics agree that huge advances in treating HIV/AIDS...may be giving some people the erroneous impression that condomless sex is risk free. It’s great that AIDS is no longer such a tragic centerpiece of gay life in America. But Weinstein worries that subsiding fear may foment riskier behavior.

“I think that people are less afraid of HIV,” he says. “We’re a victim of our own success.”

As officials continue to search for the reasons behind the surge in syphilis infections, the CDC is trying to spread the word about how risky sexually transmitted diseases can be—and how prevalent they really are. In fact, the agency now says that half of all STDs occur in people between 15 and 24 years of age, accounting for nearly $16 billion of all health care costs.

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