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Miami Concerned: Rising Syphilis Cases Could Mean Increase in AIDS - 2001-12-01

Health officials in Miami, Florida are reporting an alarming surge in syphilis infections. The concern is not so much about syphilis itself, which is easily treated with antibiotics. Rather, health officials worry that the spike in syphilis could foreshadow increases in the spread of other sexually-transmitted diseases, including HIV/AIDS.

Miami-Dade County has earned a dubious distinction, becoming one of the top-ten areas in the nation for syphilis infections. At a time when syphilis is declining overall in the United States, Miami logged a 50 percent increase last year, with 126 cases reported. The total for this year has yet to be compiled, but health officials say the surge in infections shows no sign of abating.

"It is a warning signal," says Evelyn Ullah, who heads the HIV/AIDS office at Miami-Dade County's health department. She views syphilis as a bellwether for HIV infection rates. "We have not yet seen a significant increase in new [HIV] infections in those communities where the incidence of syphilis is high. But we anticipate we will," she says.

Wendy Cousino, Community Planner at the health department, says the connection between syphilis and HIV is basic. "To contract syphilis, it is [requires] the same behavior as contracting HIV. Typically, syphilis, tuberculosis, hepatitis, gonorrhea, and the gamut of other infectious diseases are indicative [of HIV risk]. If you see the numbers going up in those particular diseases, the HIV numbers will follow," she says.

Evelyn Ullah says combating sexually transmitted diseases is no easy task in a region like south Florida, which draws hundreds of thousands of visitors every year from across the United States and abroad. "People do come to Miami to party and to have a good time. They are meeting individuals and they are having sex. The visitors come and they leave, which makes it difficult to follow and track the disease," she says.

The Miami-Dade Health Department says it is doing its best to remind people of the need to protect themselves. The department has joined with a variety of community organizations to dispatch volunteers to night clubs and other locations to distribute condoms and urge safer-sex practices.

But the director of the county's HIV/AIDS office says the general public appears to have become desensitized to the anti-AIDS message. "We have found, through discussion groups and on-the-street interviews, that people are becoming tired of the [safe sex] messages. They are engaging in risky behaviors because they believe the new AIDS drugs will save them," she says.

Health officials say the advent of HIV fighting drugs, known as protease inhibitors, has greatly increased the life span of those who contract the virus. But they worry that people may no longer fear HIV as they once did. The end result could be a shift in sexual practices away from protection. Health officials say syphilis could be the first signal of such a change, and that an increase in HIV infections could follow.