A New Twist on Sex and Syphilis

The U.S. Centers for Disease Control released a report today with the bad news that syphilis, once thought to be almost extinct, has made a comeback. Forbes covered the story:

Syphilis is back, with the rate of new cases more than doubling since 2005. “After being on the verge of elimination in 2000 in the United States, syphilis cases have rebounded,” announced Dr. Monica Patton and colleagues in this week’s Morbidity and Mortality Report, released today.

How could this be? Well, the answer is:

And the numbers are pretty clear about gender; it’s almost exclusively men getting syphilis. The proportion of new syphilis cases that were in men grew with each year studied, and in 2013, a whopping 91 percent of all new syphilis cases were in men. And almost all of those were among men who identified themselves as gay or bisexual.

Syphilis is not a disease you can take lightly. As some of you may remember from 1960s- 70s and 80s-era public health warnings, syphilis can cause dementia, blindness, and death if undetected and untreated.

Risky, unprotected sex used to be kept at bay partly by the fear of contracting syphilis, and its existence was the reason why you could buy condoms in most public men's rooms up through the 1950s--it was a public health hazard and condoms helped slow its spread.

So important was syphilis that Andrew Francis of Emory University suggested last year in an article in the Archives of Sexual Behavior that the discovery of penicillin and its ability to cure syphilis was a key reason for the explosion of new non-traditional sexual behavior in the 1950s and 1960s. He argues that once people understood that they wouldn't die (the "wages of sin") they were more wiling than ever to take risks. He also drew some interesting, and prescient, comparisons between syphilis rates in the 1930s and HIV rates in the 1990s. The lesson is a simple one, even if people don't want to pay attention--use condoms.