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Table 3.D Summary Case Study Sites - Syphilis Rates, Those at Risk for Syphilis


County
Syphilis Rates
Those at Risk for Syphilis
Hinds

MS

Early syphilis morbidity rates have decreased from a 1991 high of 102.3 per 100,000 population to less than 50 per 100,000 by 1995.
Those aged mid-20s to late 30s.

Low-income African Americans.

Exchanging sex for crack cocaine (professional prostitutes are not seen as at high risk for syphilis as crack addicts).

Men who have sex with men.

Males and females are considered equally at risk.

Humphreys

MS

Early syphilis prevalence rates in Humphreys County increased from 1991 to 1994 to a peak of 302 cases per 100,000 population. The 1995 rate dropped to 207.1 per 100,000 population.
Those aged mid-20s to late 30s.

Low-income African Americans.

Crack cocaine use and exchange of sex for drugs.

Patterns of increased teenage sexual activity.

Richland

SC

Early syphilis morbidity has remained relatively stable in Richland county between 1991 and 1995, with prevalence rates varying between 61.2 per 100,000 population and 49.3 per 100,000.
Low-income African Americans (some reporting bias suspected).

Homeless and indigent people.

Inmates in corrections institutions.

People exchanging sex for crack cocaine.

Homosexual men.

Women in their early 30s involved in serial monogamy.

Orangeburg

SC

After a 1992 peak of 147.4 cases of early syphilis per 100,000 population, the 1995 rate dropped to 16.5 per 100,000.
Lower income African Americans at greater risk than whites, but syphilis also appearing in higher socioeconomic strata.

Teens engaging in unprotected sex with multiple partners (but gonorrhea, chlamydia, or trichomoniasis more likely).

Crack cocaine use has decreased along with syphilis rates, but many treated for repeat syphilis infections are crack users.

Shelby

TN

Early syphilis morbidity has declined steadily in Shelby County between 1991 and 1995, with prevalence rates reduced from a 1991 high of 158.8 per 100,000 population to less than 60 per 100,000 by 1995.
African Americans between the ages of 20 and 29, especially those living in high-poverty areas.

Most respondents cited sex-for-crack cocaine exchanges as an important risk factor for syphilis.

Men and women are equally affected.

Commercial sex workers viewed as more likely to take care of themselves medically than crack addicts.

Tunica

MS

After a 1991 peak of 444.7 cases per 100,000 population, the early syphilis rate dropped to as low as 25 per 100,000 in 1993, and then back up to 285 per 100,000 the following year. The 1995 rate dropped to about 79 per 100,000 population.
African Americans between the ages of 15 and 30, especially those exchanging sex for crack cocaine.

Lack of recreation for teens has led to high levels of unprotected sexual activity, often with multiple partners. Poverty viewed as a risk factor, with improved economic conditions being credited with a decline in syphilis morbidity.

Montgomery

AL

Early syphilis morbidity declined sharply in Montgomery County between 1990 and 1992, with prevalence rates reduced from a 1991 high of 182.6 per 100,000 population to less than 60 per 100,000 by the next year. The rate has continued to decline from 1992 to 1995.
Drug users.

Teenagers (although syphilis more common among those in their mid-20s to late 30s).

African Americans in low-income areas.

Professional prostitutes, in contrast to crack users trading sex for drugs, are not thought to be at high risk for syphilis.

Lowndes

AL

After a 1991 peak of 165.4 cases per 100,000 population, the 1995 rate of early syphilis has dropped to 16 per 100,000 population in Lowndes County.
Low-income African Americans in their 20s and 30s.

Teen promiscuity was as strongly emphasized as sex-for-drugs exchanges (although teens are more likely to report with gonorrhea than syphilis).

Patterns of serial monogamy.

Next Table

 
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