Giving high-risk individuals antibiotics to cut their risk of syphilis does not appear to promote risky sexual behavior, according to a new study.
Giving high-risk individuals antibiotics to cut their risk of syphilis does not appear to promote risky sexual behavior, according to a new study. Investigators say their findings support launching larger studies to see whether preventive antibiotics, given to those most at risk, can stop syphilis outbreaks. Syphilis is a sexually transmitted bacterial infection that, if left untreated, can lead to serious long-term complications such as heart abnormalities, mental illness and blindness. Antibiotics–usually an injection of penicillin–are used to treat the disease, and may be given to the sexual contacts of infected people to prevent an outbreak. But the feasibility of giving antibiotics to people based solely on their risk, and not their known contact with someone with syphilis, is unclear. Experts question whether high-risk people will want the drugs, and there is concern that treatment would give a false sense of security that could encourage risky sex–and raise the risk of HIV and other incurable STDs. However, the new study of 125 high-risk African-American men in Baton Rouge, Louisiana, found that at one month and four months after receiving antibiotics, the men reported fewer sex partners and slightly higher condom use. None had contracted syphilis. Dr. Thomas A. Farley, of Tulane University in New Orleans, and his colleagues report the findings in the journal Sexually Transmitted Diseases. Men in the study were offered antibiotics to prevent syphilis after they sought STD testing at a public health clinic; all said they’d had multiple sex partners in the past year. The men had a choice of a single injection of penicillin, which gives about six weeks’ worth of syphilis protection, or three doses of oral antibiotics given at two-week intervals. The majority chose the injection. One month after treatment, 40 percent of the men said they’d had two or more sex partners in the past month, compared with 60 percent at the start of the study. Four months out, this percentage had fallen to 31 percent. The men were also slightly more likely to say they’d used a condom the last time they had sex–58 percent, versus 53 percent at the beginning of the study. Overall, 95 percent of participants asked said they would be willing to take the antibiotics again, and most were open to receiving monthly doses According to Farley’s team, preventive antibiotics given to so-called “core transmitters” of syphilis might be necessary to wipe out the STD in the U.S.–a goal of government health officials. Relatively few syphilis cases are diagnosed in the U.S. each year, and most are concentrated in Southeastern states. However, health officials reported last month that new syphilis cases were up for the second straight year in the U.S., after a steep decade-long decline that led to an all-time low in 2000. Nationwide, the total number of syphilis cases stood at 6,862 in 2002, compared with 6,103 in 2001. (Source: Sexually Transmitted Diseases (Nov 03), Reuters Health, Dec 2003)