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Syphilis rates have increased slightly after more than a decade of stabilization, according to the Centres for Disease Control and Prevention (CDC).

The syphilis rates among gay and bisexual men have increased by two percent between 2000 and 2001, from 5,979 to 6,103 cases. Overall, syphilis rates have increased from 2.1 per 100,000 to 2.2 per 100,000 people, the first national increase since 1990.

Targeted prevention efforts are necessary to curb the rates among MSM and other high risk populations. "Ultimately, our success will depend on the continued and careful targeting of our prevention resources to those areas and populations most affected by syphilis, including gay and bisexual men," said Dr Ronald O. Valdiserri, deputy director of CDC's HIV, STD and TB prevention programs.

There has been progress among certain populations -- the rates of syphilis among African Americans declined 9.9 percent between 2000 and 2001, and rates for women declined 19.5 percent overall. In the South, where the highest US Syphilis rates are, there was an eight percent decrease. The problem is syphilis rates have increased by 15.4 percent among men between 2000 and 2001, including men who have sex with men (MSM) in six US cities: Chicago, Los Angeles, Miami, New York City, San Francisco, and Seattle.

"We cannot and should not accept a rise in syphilis cases in any population as the 'way things are'," said Valdiserri. "We're beating this disease in the communities most disproportionately affected by syphilis, and we have to continue our efforts to achieve and maintain the elimination of this disease."

CDC officials are especially concerned because syphilis lesions increase the risk of HIV transmission between two and five times.

"Someone with syphilis is more likely to get infected with HIV, or if already HIV-infected, to transmit HIV to others," said Valdiserri. "Our challenge -- and the challenge for gay and bisexual communities across America -- is to underscore the connections between syphilis and HIV, and to renew the kind of commitment that these communities brought to HIV prevention in the early years of the epidemic."