[Syphilis, new epidemiologic features]

The epidemiologic survey by the InVS from data from voluntary sites shows an increase of the cases of syphilis from 2000 to 2002 in France. Most of patients with early syphilis are men having sex with men and more than half of cases is HIV infected patients. Resurgence of syphilis reflects the relapse of high-risk sexual practices and the most sexual practice evocated is unprotected oral sex. The same situation has been reported in countries from the west of Europe. In east of Europe, the epidemiology is a little bit different with an increase of cases since the early 90's mostly in sex workers and in relation to the rapid increase in the number of injecting drug users. In United States, although increases in syphilis rates among men who have sex with men have been documented since 1997, the majority of cases have been reported in the South affecting disproportionately blacks, reflecting low access to medical care but also racial segregation in sexual activity. The resurgence of syphilis while it is limited highlights the need for more health promotion initiatives especially in the most affected population.