The Syphilis elimination technical appendix
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      Since the launch of the Syphilis Elimination Effort (SEE) in 1999, there have been tremendous changes in the epidemiology of infectious syphilis in the United States. Specifically, primary and secondary (P&S) syphilis rates reached their lowest point ever in 2000 with the numbers of P&S syphilis cases in women and in African Americans decreasing every year since 1990. During 2002–2003, P&S syphilis cases declined 23.6% in women and 17.8% in African Americans.

      Despite these gains, the overall number of cases of P&S syphilis increased between 2000–2003, largely due to increases in men, associated with outbreaks in men who have sex with men (MSM). Today, syphilis remains a highly concentrated infection especially in the South and large urban centers. An estimated 60% of all new infections are occurring in MSM, many of whom are HIV positive and residents of large metropolitan areas.

      This document contains discussion papers for the SEE consultation meeting. They are meant to provide essential background information on aspects of the SEE program, and to stimulate discussion and debate on the future of the strategy.

      Each paper begins with an Executive Summary which summarizes the content and main points of the paper. The summary is then followed by the Key Questions which were considered in the consultation’s break-out sessions. The papers then recap the strategies which were recommended in the 1999 National Plan to Eliminate Syphilis from the United States before providing an assessment of progress to date (where available). The papers also summarize the published literature relevant to the topic under consideration and on this basis make recommendations for the 2006 SEE plan. The standards for the 2006 SEE plan are presented with ratings. Each chapter ends by considering ways in which the strategy may be evaluated at local or national levels.

      All material contained in this monograph was originally produced in support of the SEE Consultation meeting. The views expressed by the authors of the contained papers do not represent those of the Centers for Disease Control and Prevention (CDC).

      Suggested citation: Centers for Disease Control and Prevention. The Syphilis Elimination Technical Appendix. Atlanta, GA: US Department of Health and Human Services, May 2006.

      CDC Creative Services 104467

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