Rise in syphilis, cuts in funding a worry in Philadelphia

A spike in syphilis cases and sharp cuts in state funding to Philadelphia for HIV/AIDS are presenting a challenge to public-health workers tasked with preventing the spread of sexually transmitted diseases.

Infectious syphilis rose 45 percent in the city last year, with far greater increases among women - a group whose reported cases, while still small, barely registered until recently.

"It is very disturbing to see these outbreaks among women," said Jo Valentine, chief of syphilis elimination and STD disparities at the U.S. Centers for Disease Control and Prevention.

Local health officials have tamped down a handful of similar eruptions around the country in the last few years, Valentine said. But a 34 percent cut in state HIV funding for the city beginning July 1 - some of the money is already gone - could hamper efforts in Philadelphia, home to more than half the HIV patients in Pennsylvania.

The $2 million was used for HIV testing and prevention in minority communities, which have the highest rates of sexually transmitted diseases nationwide. It would have covered tests for an estimated 8,000 people next year, and prevention and risk-reduction services for 4,000.

All state-funded support groups aimed at prevention have already ceased to operate.

Danielle M. Parks leads a five-week risk-reduction program for heterosexual black women. The health educator's final session of SISTA - Sisters Informing Sisters about Topics on AIDS, which reached 136 women last year - was two weeks ago.

"These women need this," Parks said, because otherwise "they are going to continue life as usual."

During her last group, she told students about women who had recently tested positive for HIV. One was a 43-year-old Latina whose husband of 16 years, it turned out, had been aware of his infection for three years but did not know how to tell his wife. Another was a 36-year-old African American mother of three with private insurance and a college degree.

"It doesn't matter if you have been in a relationship for three months or 30 months," Parks told them. "Just having sex with someone who is African American puts you at higher risk, because the rates within the community are so high."

Syphilis is spread through skin-to-skin sexual contact and thus is more infectious than HIV, which is passed in bodily fluids. But they follow similar patterns, and tactics employed to prevent one often do the same for the other. Testing is considered the prime strategy.