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A significant proportion of MSM surveyed acknowledged that they had used drugs in the preceding two months, with higher rates of drug use among HIV-positive men.Twelve percent of HIV-negative men and 20 percent of HIV-positive men said they had used methamphetamines, and 37 percent of HIV-negative men and 53 percent of HIV-positive men said they had used amyl nitrate (commonly known as "poppers").

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Valdiserri also noted that CDC is studying ways to expand access to effective prevention programs for gay and bisexual men. The men were also offered testing for gonorrhea, chlamydia and syphilis.

These programs will address the unsafe sexual practices and complacency that have resulted, in part, from advances in treatment, and help men to establish and maintain safer behaviors over a lifetime. The study found that many MSM in the county reported having unprotected sexual intercourse, and that many were infected with an STD.

These data represent a dramatic resurgence of the disease in the county, where just four years earlier, in 1996, there were no syphilis cases.

The study also found that gonorrhea and chlamydia rates among MSM in the county have increased significantly in recent years.

By comparison, in 1999 the gonorrhea rate in the remainder of the county's population was approximately 44 to 49 cases per 100,000.

The researchers identified a similar trend for cases of chlamydia among MSM in the county.

Handsfield attributed the STD trends to increased frequencies of unsafe sex among MSM, likely related to improvements in treatment, which have resulted in more people living with HIV, as well as the belief among some MSM that HIV is no longer as serious a disease. D., of the University of Washington in Seattle and colleagues documented high rates of STD risk behaviors among both HIV-positive and HIV-negative MSM in Seattle.

He said the changes have significant implications for HIV transmission among MSM and for the Nation's initiative to eliminate syphilis transmission in the United States. From August 1999 through May 2000, the researchers surveyed 904 gay and bisexual men at a variety of clinical settings about their sex and drug use practices.

H., director of CDC's National Center for HIV, STD, and TB Prevention (NCHSTP).

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