Increased risky sex could have led to syphilis spike

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A pre-exposure prophylaxis, or PrEP, is a kind of drug that helps people who do not have HIV but are at high risk for contracting it prevent HIV infection.

U.S. Centers for Disease Control

A pre-exposure prophylaxis, or PrEP, is a drug that helps people who do not have HIV but are at high risk for contracting it prevent HIV infection.

Cases of syphilis have skyrocketed by nearly 60 percent in Mississippi this year, according to data released by the Mississippi Department of Health on Thursday.

So far in 2016, 214 people have been diagnosed with primary and secondary syphilis in Mississippi, compared with 136 people during the same period a year ago.

These numbers are part of a national upward trend that state health officials said could be linked to an increase in the use of Truvada, a drug that when taken by an HIV-negative person greatly reduces their risk of contracting HIV. However, Truvada does not protect against any other sexually transmitted diseases, according to the Food and Drug Administration.

“If you’re on treatment and you’re virally suppressed, there’s little to no (risk of HIV) transmission if you have risky sex,” Nick Mosca, director of the HIV and sexually transmitted disease office at the department of health, told Mississippi Today of Truvada’s effectiveness. “But the flipside … is that while we’ve been focusing on HIV, syphilis is a different animal. And Truvada isn’t going to protect you from it.”

When contacted, a spokesperson for Gilead, the company that manufactures Truvada, said the company is working to increase awareness of the risks of contracting sexually transmitted diseases while taking a pre-exposure prophylaxis, a kind of drug known in the pharmaceutical industry as a PReP.

“Gilead supports PrEP education through community-based projects and programs. We award grants to organizations that provide PrEP education to populations at high risk for HIV infections that are traditionally under-served,” said Michele Rest, a associate director of public affairs for Gilead.

In 2014, syphilis diagnoses in Mississippi increased after seven years of steady declines. This trend continued in 2015 and 2016.

Mississippi Department of Health

In 2014, syphilis diagnoses in Mississippi increased after seven years of steady declines. This trend continued in 2015 and 2016.

Mississippi mirrors national trends of syphilis rates. Although nationwide data for 2015 and 2016 is not available, the total number of cases of syphilis reported to the U.S. Centers for Disease Control increased 12.3 percent between 2013 to 2014, going from 56,482 cases to 63,450 cases. Truvada was approved in 2012.

“What we’re speculating is that people may be changing their behaviors and maybe not using condoms and not thinking about the other STDs,” Mosca said.

These other sexually transmitted diseases, specifically gonorrhea and chlamydia, have also ticked up in the last few years, both in state and nationally.

As of August 2016, 4,383 cases of gonorrhea and 12,847 cases of chlamydia had been reported in Mississippi, increasing from 3,582 cases of gonorrhea and 12,008 cases of chlamydia in 2013, the next most recent year these statistics were available from the department of health. Nationally, gonorrhea and chlamydia rose as well, going up 5.8 percent and 2.8 percent, respectively, between 2013 and 2014.

This uptick is particularly troubling, say health officials, because rates of syphilis transmission in Mississippi had been on a steady decline until 2013. That year, only 87 cases of primary and secondary syphilis were reported in state, a seven-year low. Just one year later the numbers had more than doubled to 192.

“HIV gets the attention,” Mosca said. “But (syphilis) is a problem, and we want people to be aware of that.”