In Philadelphia, the rate of primary and secondary syphilis cases was more than twice that high, at 26 cases per 100,000 people. Health experts have connected the city’s numbers in part to men who have unprotected sex with men, though the rates in women have climbed lately. Drug use and poverty also are factors.
https://www.inquirer.com/health/syphilis-gonorrhea-chlamydia-std-cdc-20191008.html
By Tom Avril
The Collected Works of Jim Garrow 