Nakashima A K, Rolfs R T, Flock M L, Kilmarx P, Greenspan J R
Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Sex Transm Dis. 1996 Jan-Feb;23(1):16-23. doi: 10.1097/00007435-199601000-00006.
The distribution and trends of syphilis are influenced by biologic factors, sexual behaviors, biomedical technology, availability of and access to health care, public health efforts, changes in population dynamics, and sociocultural factors. The objective of this article is to review the epidemiology of syphilis in the United States during the period 1941-1993 in the context of some of these factors.
Surveillance data on cases of syphilis and congenital syphilis reported by state and city health departments to the Centers for Disease Control and Prevention were analyzed to show distribution and trends by geographic location, racial and ethnic groups, gender, and age.
Historically, syphilis was distributed widely throughout the country and declined rapidly after the introduction of penicillin therapy and broad-based public health programs, attaining its lowest levels in the 1950s. However, in recent years, the disease has returned and become focused in the southern region and in urban areas outside that region. Rates of syphilis have remained highest in black Americans, and the most recent national epidemic of syphilis primarily involved them. Rates in white men were at intermediate levels during the early 1980s but have declined to low rates in the 1990s, possibly because of changes in behavior in response to the AIDS epidemic. Rates in white women and other racial and ethnic groups have remained low throughout the 1980s and 1990s.
Syphilis remains a significant problem in the United States, and its epidemiology is influenced by a complex combination of factors. To prevent and control syphilis effectively, public health practitioners must understand these factors and design programs and interventions that address the disease in the context of these factors.
梅毒的分布及发展趋势受到生物因素、性行为、生物医学技术、医疗保健的可及性与可得性、公共卫生措施、人口动态变化以及社会文化因素的影响。本文旨在结合其中一些因素，回顾1941年至1993年期间美国梅毒的流行病学情况。
分析了州和城市卫生部门向疾病控制与预防中心报告的梅毒及先天性梅毒病例的监测数据，以显示按地理位置、种族和族裔群体、性别及年龄划分的分布情况和发展趋势。
从历史上看，梅毒曾在全国广泛分布，在青霉素治疗及广泛的公共卫生项目推行后迅速下降，在20世纪50年代达到最低水平。然而，近年来，该疾病又卷土重来，且集中在南部地区以及该地区以外的城市地区。梅毒发病率在美国黑人中一直最高，最近美国梅毒的全国性流行主要涉及他们。白人男性的发病率在20世纪80年代初处于中等水平，但在20世纪90年代已降至低水平，这可能是由于对艾滋病流行做出的行为改变所致。在整个20世纪80年代和90年代，白人女性以及其他种族和族裔群体的发病率一直较低。
梅毒在美国仍然是一个重大问题，其流行病学受到多种因素的复杂综合影响。为有效预防和控制梅毒，公共卫生从业者必须了解这些因素，并设计在这些因素背景下应对该疾病的项目和干预措施。
