The resurgence of syphilis among men who have sex with men.
OBJECTIVE
To identify recent progress and emerging problems in addressing syphilis among men who have sex with men.


RESULTS
A resurgence of syphilis has occurred among men who have sex with men in many developed countries. Infection has been associated with HIV coinfection, multiple partners, and recreational drug use. Unlike HIV, oral sex appears to be a common route of syphilis transmission. Many prevention approaches have shown, at best, modest success. Variable clinical presentation and potentially inconclusive lab tests make diagnosis confusing.


CONCLUSIONS
As the infection remains relatively rare, clinicians treating men who have sex with men should maintain a high index of suspicion for syphilis lesions, and should screen their sexually active patients for latent disease. Debates about syphilis control and treatment continue. The clinical manifestations, serologic responses, efficacy of treatment, and complications of syphilis have always been complicated. HIV coinfection adds to the confusion.
Peterman
Thomas A
TA
Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. tap1@cdc.gov
Furness
Bruce W
BW
D015658:HIV Infections / Q000150:complications / Q000635:transmission; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D015229:Sexually Transmitted Diseases, Viral / Q000517:prevention & control / Q000635:transmission*; D013587:Syphilis / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*