SYPHILIS IN THE SOUTH - RURAL RATES SURPASS URBAN RATES IN NORTH-CAROLINA

We studied primary and secondary syphilis rates in North Carolina for 1985 through 1993 to elucidate demographic trends and the role of rura lity in the state's high rates. Each of the state's 100 counties was c lassified by rural-urban character; and county-level rates, adjusted f or gender, race, and age group, were compared. Syphilis rates rose dra matically during the 9-year period, with most of the increase occurrin g among women, non-Whites, and rural counties. The rural rates recentl y surpassed urban rates, with the greatest increase experienced by non -White rural women. The exchange of sex for drugs and characteristics of rural poverty may be fueling these trends.