Gay men warned of syphilis outbreaks in London and San Francisco

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Syphilis outbreaks amongst gay men have been reported in the same week in London and San Francisco. However, the outbreaks do not appear to be connected, and their probable causes speak volumes about how the world is changing.

In San Francisco, four cases of syphilis have been traced to sexual contacts made through an America OnLine internet chat room, whilst in London an undisclosed number of cases are believed to be connected to sexual contacts in eastern Europe, where the infection is epidemic.

San Francisco public health officials have had to resort to new methods of contact tracing and public education after America OnLine refused to breach the confidentiality of its service users by providing contact e-mail addresses for users of its gay chat-room. Planet Out, the AOL associate which provides the SF M4M chat room service, has posted a warning to its users, including a full description of the symptoms at its website

Glossary

syphilis

A sexually transmitted infection caused by the bacterium Treponema pallidum. Transmission can occur by direct contact with a syphilis sore during vaginal, anal, or oral sex. Sores may be found around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth, but syphilis is often asymptomatic. It can spread from an infected mother to her unborn baby.

sexually transmitted diseases (STDs)

Although HIV can be sexually transmitted, the term is most often used to refer to chlamydia, gonorrhoea, syphilis, herpes, scabies, trichomonas vaginalis, etc.

unprotected anal intercourse (UAI)

In relation to sex, a term previously used to describe sex without condoms. However, we now know that protection from HIV can be achieved by taking PrEP or the HIV-positive partner having an undetectable viral load, without condoms being required. The term has fallen out of favour due to its ambiguity.

Fuller details of the San Francisco outbreak were reported by the

San Francisco Examiner on August 23.

In London, prevention group Gay Men Fighting AIDS has issued a warning about an outbreak amongst gay men following reports from several of the city's largest STD clinics. In 1997 only 18 cases were reported throughout England amongst gay men, but several major London clinics have seen an upsurge over the past two months.

GMFA is encouraging gay men to attend STD clinics for regular check-ups. Contact details for UK STD clinics can be found at http://www.aidsmap.com/services/clinics

In both cities unprotected anal intercourse is being blamed for the outbreaks, and Jeffery Klausner, director of San Francisco Public Health Department's STD Division has emphasised that syphilis tracking is essential if new HIV infections are to be avoided, because syphilis sores may increase the risk of HIV transmission.

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