1. Sexually Transmitted Diseases Among Men Who Have Sex with Men: A need for new prevention and research strategies National Sexually Transmitted Disease Conference San Diego, California March 6, 2002

2. Background Sexually transmitted diseases (STDs) declined among men who have sex with men (MSM) at onset of AIDS epidemic In 1990s, increased STDs among MSM, nationally and internationally Consistent with behavioral data indicating increased unprotected anal sex among MSM

3. Why are increased STDs among MSM important? 1)Markers of behaviors associated with HIV transmission 2)Increase transmission and acquisition of HIV 3)STD morbidity and mortality

4. Primary and Secondary Syphilis Rates, by Sex, United States, 1981–2000 Rate (per 100,000 population) Year

5. Increases in Syphilis among MSM, 1998-2001 New York City San Francisco Los Angeles Seattle Houston Wash D.C. Chicago Miami Boston

6. Monitoring Trends in Prevalence of STDs, TB, and HIV Risk Behaviors among MSM Objectives -Assess prevalence/trends in STDs, TB and HIV risk behaviors -Enhance local prevention services Sites: STD clinic, HIV clinics, bathhouses, mobile units Data -Collected for routine care -Used for local surveillance, disease control -Submitted to CDC

7. . MSM Project Sites, 2001 Long Beach Seattle New York City San Francisco Boston Houston Wash D.C. Denver Chicago Philadelphia.........

8. Overview National STD surveillance data do not provide information regarding MSM Data from multiple sources indicate there are increases in STDs among MSM in many US cities Data from syphilis outbreak investigations and MSM Prevalence Monitoring Project should inform new prevention and research strategies

9. Symposium Presentations Syphilis outbreaks New York City Sue Blank Miami Rachel Bronzan Los Angeles Peter Kerndt MSM Project areas California Helene Calvet Washington DC Gary DeSimone Chicago Carol Ciesielski Boston Ken Mayer