By Sara Caverley
A recent syphilis outbreak in Ottawa is about 90 per cent confined to men who have sex with men, health authorities say.
The sexually transmitted infection that was thought to be eradicated has re-emerged in Ottawa’s gay community. Before 2001, there were only one or two cases in the city, says Dr. Paul MacPherson, a virologist with the Ottawa Hospital.
Now, there are 20 to 30 cases per year in Ottawa, found predominantly in gay men, he says.
MacPherson says there is speculation that the recent outbreak could be due to alterations in the virus.
“It might be that there are changes in the behavioural patterns of gay men,” he says. Many gay men feel vulnerable and marginalized, so they don’t care for themselves properly by practicing safe sex, says Gens Hellquist, executive director of the Canadian Rainbow Health Coalition. Hellquist says he contracted syphilis in the 1980s.
Syphilis is a disease that is transmitted by skin to skin contact. It is easily treated in the early stages with penicillin shots, but can lead to heart problems, brain damage and death if uncared for.
“For years we’ve told people to protect themselves using condoms,” says Christiane Bouchard, a project officer with Ottawa’s Sexual Health Centre Clinic.
“But what if the sore is close to the genitalia and not covered by the condom? Or what if a condom’s not being used for oral sex? People don’t know.”
There needs to be re-education in the community, says MacPherson.
There has been a concerted effort to teach gay men in Ottawa how the disease is transmitted. Posters and pamphlets prepared by the AIDS Committee of Ottawa and Pink Triangle Services are circulating in local gay venues.
An animated public service announcement is being played in gay bars and saunas.
The video was developed by gay community and public health agencies in Ottawa, Toronto and Montreal to raise awareness about the disease’s resurgence in Canada.
“To withhold education from any part of the population would not be appropriate,” says MacPherson.
“But with gay men, it’s a double-ended sword, because they’re tarred with the brush of being promiscuous.”
He says since syphilis is prevalent among gay men, the information needs to be targeted at them, but must also carefully avoid stereotyping the gay community.
The prevalence of syphilis is up in urban areas across the country, as well as in the United States, United Kingdom and China.
It is isolated to the heterosexual community in Winnipeg and started with heterosexual couples in Calgary before emerging in the gay population, says Hellquist, who lives in Saskatoon.
“If people think this is just going to stay in gay communities – they’re very wrong,” he says.
People with multiple sex partners or high-risk sexual behaviour should get tested for syphilis every three months, says Bouchard. Patients too often think their doctor tests for all sexually transmitted infections during their regular checkup, when in fact, they hardly ever check for syphilis, she says. People need to take responsibility and be proactive.
“It still perplexes me why people like to have sex and talk about sex, but they don’t want to talk about the other side – the bad stuff,” says MacPherson. “People need to know that syphilis is easily picked up, and it’s easily treated. They are going to know this if people talk about it.”