Synopsis for February 23, 2001

MMWR articles are embargoed until 4 p.m. E.S.T. Thursdays.

1. Primary and Secondary Syphilis — United States, 1999
2. Outbreak of Syphilis Among Men Who Have Sex with Men — Southern California, 2000
3. Prevalence of Disabilities and Associated Health Conditions Among Adults — United States, 1999

MMWR Fact Sheet

February 23, 2001
Contact: Office of Communication
CDC, National Center for Chronic Disease Prevention
& Health Promotion
(770) 488–5131

Fact Sheet: Disabilities and Associated Health Conditions

Synopsis for February 23, 2001

Primary and Secondary Syphilis — United States, 1999

Despite a 10 percent decline in syphilis rates for African Americans from 1998 to 1999, African Americans remain disproportionately affected by syphilis.

Reported rates of primary and secondary (P&S) syphilis in 1999 were 30 times higher for African Americans than for white Americans. The continued impact of syphilis on African Americans likely reflects the effects of poverty and lack of access to or use of quality health care services. During this same time period, P&S syphilis rates increased 20 percent for Hispanics, but were stable for white Americans. The increase in Hispanic rates occurred primarily among men, possibly reflecting the recent outbreaks in men who have sex with men. In order to maintain progress toward syphilis elimination, CDC recommends continued efforts to educate and screen people at high-risk for syphilis, maintain high-quality reporting and case finding, and expand services for hard-hit communities. Syphilis increases the likelihood of HIV transmission and can compromise reproductive health; e.g., miscarriages, stillbirths.

Outbreak of Syphilis Among Men Who Have Sex with Men — Southern California, 2000

CDC, along with local health officials, conducted an investigation of an outbreak of syphilis among a group of mostly white and Latino gay and bisexual men in Southern California.

Results of the investigation suggest increases in risk behavior among some groups of men who have sex with men (MSM), including HIV-positive men. Between January and July 2000, 66 cases of syphilis were reported among MSM, representing a 96% increase from the 26 cases reported among MSM during the same time period in 1999. Most of the MSM involved in the outbreak were white (39 percent) or Latino (36 percent), and 60 percent were infected with HIV. Fifty percent of the MSM reported anonymous sex, nearly 26 percent reported meeting partners at bath houses, and only 20 percent reported using a condom during their last sexual encounter. Prevention counseling and screening and treatment for all STDs should become standard practice in private and public health facilities serving people infected with HIV. Moreover, it is critical to intensify prevention efforts for MSM to prevent continued outbreaks.

Prevalence of Disabilities and Associated Health Conditions Among Adults — United States, 1999

Disability continues to be a large public health problem, especially for the working age population; and arthritis, back problems and heart trouble remain the leading causes.

Disability remains a large public health problem, affecting over 44 million (22%) people in 1999. Although half of older adults have a disability, most (63%) people with a disability are working age (18-64 years). Arthritis and rheumatism (17.5%) and back or spine problems (16.5%) lead the list of conditions associated with disability, followed by heart trouble (7.8%) and lung or respiratory problems (4.7%). Women report arthritis and rheumatism as the main cause of their disability more often than men (22.4% women versus 11.0% men), while men (9.4%) report more heart trouble than women (6.6%). The increasing life expectancy of the population is likely to accentuate the impact and importance of disability over the next 30 years.

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