…to 57 percent in 2011, according to the CDC. But while it is clear that syphilis is spreading fast, and that it is spreading especially among men having sex with men, public health and medical experts still don’t know the answers to some really basic and important questions.
“We haven’t really seen enough data to help us understand why there is this increase,” says Jay Laudato, executive director of the Callen-Lorde Community Health Center, which provides health care to New York’s LGBT communities.
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One theory is that the disease may be spreading in part because HIV-positive gay men are choosing to have unprotected sex with HIV-positive partners, a phenomenon called seroadaptation or serosorting. In one important respect, this is a laudable risk-reduction strategy that can protect exposing HIV-negative people to HIV. But it can also put HIV-positive men at greater risk for STIs like syphilis. Many of the men having sex with men diagnosed with syphilis, CDC data indicate, are also HIV-positive.