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Sexually transmitted diseases

HIV, syphilis cluster in teens, adults found in Milwaukee

Mary Spicuzza
Milwaukee
An HIV test kit

MILWAUKEE — At least 125 people — including some high school students — have contracted HIV, syphilis or both in one of the largest sexually transmitted infection clusters discovered in this city of 600,000, health care advocates confirmed to the Journal Sentinel

Three babies also were born locally with syphilis last year, health officials said.

“This is an epidemic people are not talking about enough, and it leads to people taking unnecessary risks,” said Melissa Ugland, a public health consultant who works with a number of Milwaukee nonprofit organizations that focus on public health.

The Milwaukee Health Department has made no announcement to the general public as of early Thursday. The federal Centers for Disease Control and Prevention has not publicly identified areas of the country with clusters of HIV and syphilis as it often does with other communicable diseases such as measles or hepatitis.

► March 7:Needle exchange program reduces sharing in city battered by HIV
► March 5:Louisville is epicenter for more than 100 cases of hepatitis A
► Jan. 9:HIV spike linked to injection-drug use hits Cincinnati area

Fewer than 10% of the 125 people who tested positive are Milwaukee Public Schools students, but health care experts anticipate that those numbers could increase as more people come forward.

A cluster is an aggregation of disease closely grouped in time and place. This cluster was identified because the people in it could all be connected, and were in contact with each other during a 12-month, identifiable period, Ugland said.

Most of those in the group are men and 45% were HIV positive, Ugland and other health-care advocates said. 

Ugland said she did not know which school or schools the cluster affected but said several could be. 

In a statement, Milwaukee Public Schools officials said the health department informed the school district that the entire city is experiencing an increase in sexually transmitted infections in young people ages 15 to 24.

"Because schools have a significant number of students in the 15-18 age group, we are working with the Milwaukee Health Department, in a collaborative and preventive effort, to share information with young people in middle schools and high schools to keep them healthy and to protect their health," the statement said.  

The cluster is still considered to be growing.

"They were continuing to try to track down some folks,” Ugland said.

Bevan Baker, the city's former health commissioner, met with Mayor Tom Barrett to brief him about the cluster in December and again in early January, about a week before Baker resigned over troubles with Milwaukee's lead poisoning prevention programs.

► Sept. 26:Sexually transmitted diseases hit record U.S. high, officials say
► July 11:Syphilis rates are on the rise, and dating apps may play a role

Last week, the Milwaukee Health Department launched a series of advertisements promoting free, confidential sexually transmitted disease at two sites, health officials said Tuesday.

Public health advocates are labeling the cluster a “sentinel event” because of the number of young people becoming HIV positive and the fact that babies were born with syphilis.

“It’s a really big deal,” Ugland said. 

► June 22:Teens are having less sex and using more protection
► May 11:Hepatitis C infections tripled in five years

Syphilis can be cured easily without long-term problems with penicillin. But if left untreated, the STD can damage the heart, blood vessels, brain and nervous system and that damage cannot be repaired. 

Congenital syphilis, transmitted in utero from mother to child, can cause birth defects or a baby's death. 

Health officials first became aware of a growing problem with sexually transmitted infections in mid-December after several people reported having HIV or syphilis symptoms.

► July 2016:Prince Harry takes an instant HIV test to raise public awareness
► June 2016:Increased testing needed to combat rising syphilis infections

When people tested positive, they were referred for care and interviewed about their sexual history. Officials attempt to find out who those infected had sex with and reach out to sexual partners to try to get them tested and in for treatment.

While some people in the cluster have been upfront with information on their sexual contacts, others have been hesitant to give out names, advocates said.

Many people fail to come forward out of fear of being stigmatized, community volunteer Gary Hollander said. He's also former chief executive of Diverse and Resilient, a grass-roots organization that gives a voice to LGBT issues.

When dealing with a cluster this big, health officials need to move quickly. The viruses and bacterial infections can spread fast, Hollander said.

Syphilis symptoms can develop 10 to 90 days after contact but usually occur within three weeks. A firm, round, painless sore forms around the original site of the infection.

People who don’t get that treated might get additional symptoms, such as a rash on the palm of the hands or feet. 

As for HIV, since the virus is no longer viewed as a death sentence, as it was during the 1980s and 1990s, people have become lax and stopped preventive measures that caused sexually transmitted infections to drop, Hollander said. That includes wearing a condom during sex, knowing their status, talking to their partners and making sexual health a part of their health routine.

► November 2015:More babies being born with syphilis
► October 2015:Syphilis cases up among active-duty troops

“That’s the unfortunate part,” he said.

People are living longer, productive lives with HIV, and new medications like pre-exposure prophylaxis (or PrEP) have been shown to prevent its spread entirely. 

HIV symptoms vary and it can take several years for the symptoms to present itself. That makes it easy for a person living without symptoms to spread the disease without knowing.

► October 2015:Pregnancy rate, STD stats show sex ed in U.S. not working
► May 2015:Indiana community's HIV outbreak a warning to rural America

“The best way to know is to get tested,” Hollander said.

When Milwaukee Public Schools discovered the news they immediately had health care professionals in to talk with students, Ugland said.

While not having sex is the best way to prevent sexually transmitted infections, Ugland said some young people don’t have that choice in part because of crimes such as sex trafficking.

News of the cluster should be a wake-up call that the infections remain a public health crisis, much like the flu or mumps, Hollander said.

► May 2015:Hepatitis C infections soaring, fueled by prescription painkiller abuse
► April 2015:After hitting historic low in 2000, syphilis is on the rise

The Milwaukee metro area already has led the nation gonorrhea rates in 2015 and 2016, according to a federal Centers for Disease Control and Prevention report.. It ranked sixth in chlamydia cases per 100,000 population.

People ages 15 to 24 make up 37.4% of the HIV cases in Milwaukee, while people ages 20 to 29 make up 57.1% of the syphilis cases, according to the Milwaukee Health Department. 

Follow James E. Causey and Mary Spicuzza on Twitter: @jecausey and @MSpicuzzaMJS

More

► August 2014:Gay bathhouses nationwide face uncertain future
► January 2014:Reaching out to prevent HIV in high-risk youth
► November 2012:Panel recommends routine HIV tests for teens, adults

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