0
September 19, 1990, Vol 264, No. 11 >
ARTICLE | September 19, 1990

Epidemiology of Primary and Secondary Syphilis in the United States, 1981 Through 1989 FREE

Robert T. Rolfs, MD; Allyn K. Nakashima, MD
[+] Author Affiliations

Reprint requests To Technical Information Services, Center for Prevention Services, Centers for Disease Control (E06), Atlanta, GA 30333.


JAMA. 1990;264(11):1432-1437. doi:10.1001/jama.1990.03450110078031
Text Size: A A A
Published online
Article
References

Between 1981 and 1989, the incidence of primary and secondary syphilis in the United States increased 34%, from 13.7 to 18.4 cases per 100 000 persons, the highest since 1949. The populations affected most by syphilis also changed substantially. From a peak of 10.0 cases per 100 000 persons in 1982, the incidence among white men had decreased 69% by 1989 (3.2 cases per 100 000 persons). From 1982 to 1985, the incidence also decreased among black men (30%, 101.9 to 71.5 cases per 100 000) and black women (22%, 45.8 to 35.8 cases per 100 000). However, in 1986 this trend reversed, and the incidence among blacks more than doubled from 1985 to 1989 (52.6 to 121.8 cases per 100 000 persons). Racial differences in syphilis incidence increased (black-to-white incidence rate ratio in 1981 was 14.5 and in 1989 was 47.8), as did regional differences. Trends in syphilis incidence indicate changes in sexual behavior that may determine future sexual transmission of human immunodeficiency virus. Targeting resources at populations most affected by this recent epidemic is an urgent public health priority.

(JAMA. 1990;264:1432-1437)

REFERENCES

1 +
Fichtner RR, Aral SO, Blount JH, Zaidi AA, Reynolds GH, Darrow WW.  Syphilis in the United States: 1967-1979 . Sex Transm Dis. 1983;;10:77-80.
2 +
Greenblatt RM, Lukehart SA, Plummer FA, et al.  Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS . 1988;; 2:47-50.
3 +
Holmberg SD, Stewart JA, Gerber AR, et al.  Prior herpes simplex virus type 2 infection as a risk factor for HIV infection . JAMA . 1988;;259:1048-1050.
4 +
Pepin J, Plummer FA, Brunham RC, et al.  The interaction of HIV infection and other sexually transmitted diseases: an opportunity for intervention . AIDS . 1989;;3:3-9.
5 +
Simonsen JN, Cameron W, Gakinya MN, et al.  Human immunodeficiency virus infection among men with sexually transmitted diseases: experience from a center in Africa . N Engl J Med. 1988;;319:274-278.
6 +
Stamm WE, Handsfield HH, Rompalo AM, et al.  The association between genital ulcer disease and acquisition of HIV infection in homosexual men . JAMA . 1988;;260:1429-1433.
7 +
Bureau of the Census. United States Population Estimates by Age, Sex and Race: 1980-1988 . Washington, DC: Dept of Commerce; 1990;:2, 55-60. Series P-25, No. (1045) .
8 +
Bureau of the Census. United States Population Estimates by Age, Sex and Race: 1989 . Washington, DC: Dept of Commerce; 1990;:3, 12-15. Series P-25, No. (1057) .
9 +
Bureau of the Census. State Population and Household Estimates: July 1, 1989 . Washington, DC: Dept of Commerce; 1990;:5. Series P-25, No. (1058) .
10 +
Irwin R. 1980-1988 Intercensal Population Estimates by Race, Sex, and Age . Alexandra, Va: Demo-Detail; 1989;. Machine readable data file.
11 +
Kahn HA. An Introduction to Epidemiologic Methods . New York, NY: Oxford University Press; 1983;.
12 +
Centers for Disease Control.  Continuing increase in infectious syphilis—United States . MMWR . 1988;;37:35-38.
13 +
Centers for Disease Control.  Increases in primary and secondary syphilis—United States . MMWR . 1987;;36:393-397.
14 +
Centers for Disease Control.  Declining rates of rectal and pharyngeal gonorrhea among males— New York City . MMWR . 1984;;33:295-297.
15 +
Judson FN.  Fear of AIDS and gonorrhea rates in homosexual men . Lancet . 1983;;2:159-160.
16 +
Handsfield HH.  Decreasing incidence of gonorrhea in homosexually active men: minimal effect on risk of AIDS . West J Med. 1985;;143:469-470.
17 +
Centers for Disease Control.  Trends in gonorrhea in homosexually active men—King County, Washington, 1989 . MMWR . 1989;;38:762-764.
18 +
Landrum S, Beck-Sague C, Kraus S.  Racial trends in syphilis among men with same-sex partners in Atlanta, Georgia . Am J Public Health. 1988;;78:66-67.
19 +
Centers for Disease Control.  Early syphilis— Broward County, Florida . MMWR . 1987;;36:221-223.
20 +
Lee CB, Brunham RC, Sherman E, Harding GKM.  Epidemiology of an outbreak of infectious syphilis in Manitoba . Am J Epidemiol. 1987;; 125:277-283.
21 +
Andrus JK, Fleming DW, Harger DR, et al.  Partner notification: can it control epidemic syphilis? Ann Intern Med. 1990;;112:539-543.
22 +
Rolfs RT, Goldberg M, Sharrar RG.  Risk factors for syphilis: cocaine use and prostitution . Am J Public Health. 1990;;80:853-857.
23 +
Centers for Disease Control.  Relationship of syphilis to drug use and prostitution—Connecticut and Philadelphia, Pennsylvania . MMWR . 1988;; 37:755-758.
24 +
Centers for Disease Control.  Congenital syphilis—New York City, 1986-1988 . MMWR . 1989;;48: 825-829.
25 +
Handsfield HH, Rice RJ, Roberts MC, Holmes KK.  Localized outbreak of penicillinase-producing Neisseria gonorrhoeae: paradigm for introduction and spread of gonorrhea in a community . JAMA . 1989;;261:2357-2361.
26 +
Schwarcz SK, Bolan GA, Fullilove M,  McCright, Kohn R. Crack cocaine as a risk factor for gonorrhea among black teenagers . Presented at the 117th Annual Meeting of the American Public Health Association; October 2-26, 1989; Chicago, Ill.
27 +
McLaughlin M, Wilkes M, Blum S, Hermoso A, Schmid G.  Risks associated with acquiring chancroid genital ulcerative disease and HIV infection: a case control study . Presented at the Fifth International Conference on AIDS; June 4-9,1989; Montreal, Canada .
28 +
Fullilove RE, Thompson MT, Bowser BP, Gross SA.  Risk of sexually transmitted disease among black adolescent crack users in Oakland and San Francisco, Calif. JAMA . 1990;;263:851-855.
29 +
Centers for Disease Control.  Update: acquired immunodeficiency syndrome — United States, 1989 . MMWR. 1990;;39:81-86.
30 +
Centers for Disease Control.  Progress toward achieving the 1990 objectives for the nation for sexually transmitted diseases . MMWR . 1990;;39: 53-57.
31 +
Quinn TC, Mann JM, Curran JW, Piot P.  AIDS in Africa: an epidemiologic paradigm . Science . 1986;;234:955-966.
32 +
Hahn RA, Magder LS, Aral SO, Johnson RE, Larsen SA.  Race and the prevalence of syphilis seroreactivity in the United States population: a national sero-epidemiologic study . Am J Public Health. 1989;;79:467-470.
33 +
Aral SO, Cates W.  The multiple dimensions of sexual behavior as risk factor for sexually transmitted disease: the sexually experienced are not sexually active . Sex Transm Dis. 1989;;16:173-177.
34 +
Weinberg MS, Williams CJ.  Black sexuality: a test of two theories . J Sex Res. 1988;;25:197-218.
35 +
Moran JS, Aral SO, Jenkins WC, Peterman TA, Alexander ER.  The impact of sexually transmitted diseases on minority populations . Public Health Rep. 1989;;104:560-565.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Fichtner RR, Aral SO, Blount JH, Zaidi AA, Reynolds GH, Darrow WW.  Syphilis in the United States: 1967-1979 . Sex Transm Dis. 1983;;10:77-80.
2 +
Greenblatt RM, Lukehart SA, Plummer FA, et al.  Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS . 1988;; 2:47-50.
3 +
Holmberg SD, Stewart JA, Gerber AR, et al.  Prior herpes simplex virus type 2 infection as a risk factor for HIV infection . JAMA . 1988;;259:1048-1050.
4 +
Pepin J, Plummer FA, Brunham RC, et al.  The interaction of HIV infection and other sexually transmitted diseases: an opportunity for intervention . AIDS . 1989;;3:3-9.
5 +
Simonsen JN, Cameron W, Gakinya MN, et al.  Human immunodeficiency virus infection among men with sexually transmitted diseases: experience from a center in Africa . N Engl J Med. 1988;;319:274-278.
6 +
Stamm WE, Handsfield HH, Rompalo AM, et al.  The association between genital ulcer disease and acquisition of HIV infection in homosexual men . JAMA . 1988;;260:1429-1433.
7 +
Bureau of the Census. United States Population Estimates by Age, Sex and Race: 1980-1988 . Washington, DC: Dept of Commerce; 1990;:2, 55-60. Series P-25, No. (1045) .
8 +
Bureau of the Census. United States Population Estimates by Age, Sex and Race: 1989 . Washington, DC: Dept of Commerce; 1990;:3, 12-15. Series P-25, No. (1057) .
9 +
Bureau of the Census. State Population and Household Estimates: July 1, 1989 . Washington, DC: Dept of Commerce; 1990;:5. Series P-25, No. (1058) .
10 +
Irwin R. 1980-1988 Intercensal Population Estimates by Race, Sex, and Age . Alexandra, Va: Demo-Detail; 1989;. Machine readable data file.
11 +
Kahn HA. An Introduction to Epidemiologic Methods . New York, NY: Oxford University Press; 1983;.
12 +
Centers for Disease Control.  Continuing increase in infectious syphilis—United States . MMWR . 1988;;37:35-38.
13 +
Centers for Disease Control.  Increases in primary and secondary syphilis—United States . MMWR . 1987;;36:393-397.
14 +
Centers for Disease Control.  Declining rates of rectal and pharyngeal gonorrhea among males— New York City . MMWR . 1984;;33:295-297.
15 +
Judson FN.  Fear of AIDS and gonorrhea rates in homosexual men . Lancet . 1983;;2:159-160.
16 +
Handsfield HH.  Decreasing incidence of gonorrhea in homosexually active men: minimal effect on risk of AIDS . West J Med. 1985;;143:469-470.
17 +
Centers for Disease Control.  Trends in gonorrhea in homosexually active men—King County, Washington, 1989 . MMWR . 1989;;38:762-764.
18 +
Landrum S, Beck-Sague C, Kraus S.  Racial trends in syphilis among men with same-sex partners in Atlanta, Georgia . Am J Public Health. 1988;;78:66-67.
19 +
Centers for Disease Control.  Early syphilis— Broward County, Florida . MMWR . 1987;;36:221-223.
20 +
Lee CB, Brunham RC, Sherman E, Harding GKM.  Epidemiology of an outbreak of infectious syphilis in Manitoba . Am J Epidemiol. 1987;; 125:277-283.
21 +
Andrus JK, Fleming DW, Harger DR, et al.  Partner notification: can it control epidemic syphilis? Ann Intern Med. 1990;;112:539-543.
22 +
Rolfs RT, Goldberg M, Sharrar RG.  Risk factors for syphilis: cocaine use and prostitution . Am J Public Health. 1990;;80:853-857.
23 +
Centers for Disease Control.  Relationship of syphilis to drug use and prostitution—Connecticut and Philadelphia, Pennsylvania . MMWR . 1988;; 37:755-758.
24 +
Centers for Disease Control.  Congenital syphilis—New York City, 1986-1988 . MMWR . 1989;;48: 825-829.
25 +
Handsfield HH, Rice RJ, Roberts MC, Holmes KK.  Localized outbreak of penicillinase-producing Neisseria gonorrhoeae: paradigm for introduction and spread of gonorrhea in a community . JAMA . 1989;;261:2357-2361.
26 +
Schwarcz SK, Bolan GA, Fullilove M,  McCright, Kohn R. Crack cocaine as a risk factor for gonorrhea among black teenagers . Presented at the 117th Annual Meeting of the American Public Health Association; October 2-26, 1989; Chicago, Ill.
27 +
McLaughlin M, Wilkes M, Blum S, Hermoso A, Schmid G.  Risks associated with acquiring chancroid genital ulcerative disease and HIV infection: a case control study . Presented at the Fifth International Conference on AIDS; June 4-9,1989; Montreal, Canada .
28 +
Fullilove RE, Thompson MT, Bowser BP, Gross SA.  Risk of sexually transmitted disease among black adolescent crack users in Oakland and San Francisco, Calif. JAMA . 1990;;263:851-855.
29 +
Centers for Disease Control.  Update: acquired immunodeficiency syndrome — United States, 1989 . MMWR. 1990;;39:81-86.
30 +
Centers for Disease Control.  Progress toward achieving the 1990 objectives for the nation for sexually transmitted diseases . MMWR . 1990;;39: 53-57.
31 +
Quinn TC, Mann JM, Curran JW, Piot P.  AIDS in Africa: an epidemiologic paradigm . Science . 1986;;234:955-966.
32 +
Hahn RA, Magder LS, Aral SO, Johnson RE, Larsen SA.  Race and the prevalence of syphilis seroreactivity in the United States population: a national sero-epidemiologic study . Am J Public Health. 1989;;79:467-470.
33 +
Aral SO, Cates W.  The multiple dimensions of sexual behavior as risk factor for sexually transmitted disease: the sexually experienced are not sexually active . Sex Transm Dis. 1989;;16:173-177.
34 +
Weinberg MS, Williams CJ.  Black sexuality: a test of two theories . J Sex Res. 1988;;25:197-218.
35 +
Moran JS, Aral SO, Jenkins WC, Peterman TA, Alexander ER.  The impact of sexually transmitted diseases on minority populations . Public Health Rep. 1989;;104:560-565.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems