Heffelfinger James D, Swint Emmett B, Berman Stuart M, Weinstock Hillard S
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Ga 30333, USA.
Am J Public Health. 2007 Jun;97(6):1076-83. doi: 10.2105/AJPH.2005.070417. Epub 2007 Apr 26.
We assessed the epidemiology of primary and secondary syphilis in the United States and estimated the percentages of cases occurring among men who have sex with men (MSM).
We reviewed US syphilis surveillance data from 1990 through 2003. We estimated the number of cases occurring among MSM by modeling changes in the ratio of syphilis cases among men to cases among women.
During 1990 through 2000, the rate of primary and secondary syphilis decreased 90% overall, declining 90% among men and 89% among women. The overall rate increased 19% between 2000 and 2003, reflecting a 62% increase among men and a 53% decrease among women. In 2003, an estimated 62% of reported cases occurred among MSM.
Increasing syphilis cases among MSM account for most of the recent overall increase in rates and may be a harbinger of increasing rates of HIV infection among MSM. National efforts are under way to improve monitoring of syphilis trends, better understand factors associated with the observed increases, and improve efforts to prevent syphilis transmission.
我们评估了美国一期和二期梅毒的流行病学情况，并估计了男男性行为者（MSM）中梅毒病例的占比。
我们回顾了1990年至2003年美国梅毒监测数据。通过对男性梅毒病例与女性梅毒病例比例变化进行建模，我们估计了男男性行为者中的梅毒病例数。
1990年至2000年期间，一期和二期梅毒的总体发病率下降了90%，男性下降了90%，女性下降了89%。2000年至2003年期间，总体发病率上升了19%，这反映出男性发病率上升了62%，女性发病率下降了53%。2003年，估计62%的报告病例发生在男男性行为者中。
男男性行为者中梅毒病例的增加是近期总体发病率上升的主要原因，可能预示着男男性行为者中艾滋病毒感染率的上升。国家正在努力加强对梅毒趋势的监测，更好地了解与观察到的发病率上升相关的因素，并加大预防梅毒传播的力度。
