While gonorrhea has fallen to record lows, syphilis and chlamydia are on the rise, posing serious health threats to men and women, researchers said. 

In 2004, Atlanta had the second-highest rate of syphilis � after San Francisco � among 25 U.S. cities, according to trend data on sexually transmitted diseases released Tuesday by the Centers for Disease Control and Prevention. Georgia has historically had one of the nation's highest rates of syphilis.

Atlanta reported 283 cases of syphilis or a rate of 34.6 cases per 100,000 people. The national rate is 2.7 cases per 100,000.

While progress has been made in preventing, diagnosing and treating sexually transmitted disease in recent years, health officials said several factors could explain the upward spiral of syphilis and chlamydia after both diseases had declined.

Reported increases of chlamydia, which can cause ectopic pregnancies and infertility in women, may be a result of better detection and awareness. The chlamydia rate rose to 319.6 cases per 100,000 in 2004, up about 6 percent from the year before.

Rates of sexually transmitted diseases have historically been highest in the Southeast. Mississippi, Louisiana and South Carolina have the highest gonorrhea rates in the new report. The states with the highest rates of chlamydia are Mississippi, Alaska and Louisiana. Among cities, Detroit and St. Louis lead both categories.

The CDC estimates that men having sex with men comprised 64 percent of syphilis cases in 2004, up from 5 percent in 1999.

"It's very clear that for the last four years, when we've seen an increase it's primarily been in men and predominantly in men who have sex with men," said Dr. Ronald Valdiserri, acting director of the CDC's National Center for HIV, STD and TB Prevention. "We know that's being fueled by increases in high-risk sexual behavior."

Methamphetamine use and meeting sexual partners on the Internet are exacerbating syphilis transmission because both behaviors lead to risky sex, researchers said.

Syphilis, gonorrhea and chlamydia are caused by bacteria and can be treated with antibiotics. Victims are three to five times more likely to acquire HIV, the virus that causes AIDS, if that person is exposed.

Black women continue to be disproportionately affected by chlamydia, with rates that are more than 7.5 times that of white women. African-American people also continue to be most at-risk for gonorrhea, with rates that are 19 times greater than for whites.

Syphilis rates among African-Americans also increased in 2004, after a decade of significant decline. The overall rate among blacks increased almost 17 percent, from 7.7 cases per 100,000 in 2003 to 9 cases per 100,000 in 2004.

Many STDs have silent symptoms and remain undiagnosed. That, in addition to the lack of adequate STD testing, leads researchers to estimate there are about 19 million STD infections each year, almost half of them among people ages 15 to 24.

A total of 929,462 cases of chlamydia were reported last year. But there may be an many as 2.8 million new cases occurring each year.

While 330,132 cases of gonorrhea were reported last year, the CDC predicts there really may be as many as 700,000 cases each year.

Offering testing for all sexually transmitted diseases when people are seeking HIV screening could help increase the rate of diagnosis and decrease transmission, officials said.

"We're trying to get more STD testing here because people are requesting it, and not just gay men, " said Greg Smith, director of prevention services at AIDS Survival Project, a nonprofit resource and advocacy organization in downtown Atlanta. "In our treatment centers, we're finding more and more people in need of treament for STDs, particularly syphilis."

By PATRICIA GUTHRIE
Cox News Service

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