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Prompted by more than a two-fold increase in syphilis cases over the last three years, Virginia health officials on Monday kicked off an education campaign to increase awareness about the infection.

In 2003, cases in the state hit a historic low. "We were talking about actually eliminating the disease. as a public health problem," said Robert Johnson, director of outbreak response for the Virginia Health Department. Then in 2004, cases of the STD started increasing by double-digit percentages. Syphilis increased 31 percent, to 352 cases, last year. In the first quarter of 2007, cases spiked 39 percent compared with the same period for 2006.

According to health officials, the increase is linked mainly to transmission among men who have sex with men. In some instances, these men are HIV-positive and are no longer practicing safe sex; others may not be heeding safe-sex warnings, said officials.

Syphilis' resurgence in Virginia mirrors what is occurring nationally, including in the District of Columbia. In 2000, the District recorded a record-low 38 cases. By last year, that number was 115. In Virginia, almost two-thirds of syphilis cases last year were among African Americans. District cases were almost equally divided between blacks and whites.

Maryland has managed to buck the trend. In 2005, the most recent year for which figures are available, it recorded 313 syphilis cases, down from 380 the year before.

Virginia officials are focusing their education efforts in Northern Virginia and the Norfolk and Richmond areas. Signs promoting testing are being posted in 125 buses on routes across Fairfax County and into Arlington. Beginning in June, local radio and cable stations will broadcast awareness announcements in English and Spanish.