Introduction Men who have sex with men (MSM) accounted for 61.1% of reported primary and secondary (P and S) syphilis cases in the United States in 2014. Of P and S syphilis cases among MSM with known race/ethnicity, 94.7% were either White (40.3%), Black (32.2%), or Hispanic (22.2%). To examine rates of P and S syphilis among racial/ethnic categories of MSM, national and state-level estimates of the number of MSM of each race/ethnicity are needed.

Methods We calculated race/ethnicity-specific rates of P and S syphilis among adult MSM (age ≥18) in 49 states that reported sex of partners and race/ethnicity for syphilis cases in 2014. Case counts of P and S syphilis were from national case report data, which are submitted from states to CDC. For rate denominators, we amended our previously published method to produce stratified estimates and 95% confidence intervals (CI) for seven racial/ethnic groups: Hispanic MSM of any race and non-Hispanic MSM who were White; Black; American Indian; Asian; Pacific Islander; or multiple races.

Results The rate of reported P and S syphilis among MSM in the US was 255.4 (95% CI: 229.1–284.7) per 1 00 000 in 2014. The rates of P and S syphilis per 1 00 000 among the three racial/ethnic groups most represented among MSM cases were 170.0 (151.1–191.0) for White MSM, 286.4 (250.1–329.5) for Hispanic MSM, and 604.3 (525.0–700.8) for Black MSM, the highest of all racial/ethnic groups. Asian MSM had the lowest rate at 106.9 (91.4–125.4) per 1 00 000. Comparing the 3 most-represented racial/ethnic groups, the rate was highest among Black MSM in 37 states, Hispanic MSM in 7 states, and White MSM in 5 states. Of states with ≥100 cases among Black MSM, South Carolina had the highest rate at 1,398.1 (941.6–2,119.0) per 1 00 000.

Conclusion These are the first race/ethnicity-specific estimates of P and S syphilis rates among MSM for states with reported sexual behaviour of cases. Although more cases of P and S syphilis were reported among White MSM in 2014, the rate among Black MSM was higher than White or Hispanic MSM in most states and was over 3.5 times that of White MSM in the US.