Skin lesion with syphilis bacteria (Treponema pallidum) under microscope (1000x magnification) Getty Images

Racial and Ethnic Minorities Disproportionately Affected

The number of syphilis cases in the U.S. are on the rise. According to a new report from the Centers for Disease Control and Prevention, cases increased by nearly 80% to more than 207,000 between 2018 and 2022.

Rates increased among all age groups, including newborns, and in all regions of the country. In 2022, 3,755 cases of babies born with syphilis in the U.S. were reported, which reflects an alarming 937% increase in the past decade, the CDC said.

The report continued that racial and ethnic minorities are most disproportionately affected due to “long standing social inequities that often lead to health inequalities.”

Experts point to various reasons for the increase, including increases in substance abuse tied to risky sexual behavior, decrease in condom use, ongoing social and economic conditions and reduction in sexually transmitted infections (STI) services at the state and local level.

“Because STIs often do not show symptoms, and screening is necessary for timely diagnosis and treatment, changes in access to sexual health care can affect the number of infections diagnosed and reported,” the CDC said.

The stigma surrounding STIs can also keep people from seeking care, and “buries the truth that all people deserve quality sexual health care,” said Laura Bachmann, acting director of the CDC’s Division of STD Prevention, in an interview with NPR. “It also can cause issues at the provider level when it comes to talking with people about these issues.”

The CDC said that its findings signal an urgent need for a closer look at public health efforts and prevention strategies.

“Some people face tremendous barriers to STI prevention and health services,” said Bachmann in a statement. “So, the most important work is often outside the clinic, whether it be reaching out to communities with testing, interviewing patients to offer services to their partners, or delivering treatment directly to someone.”

She added that there is still a need for more innovation around diagnosis, treatment and prevention.

“In the United States, syphilis was close to elimination in the 1990s, so we know it’s possible to reverse this epidemic,” said Jonathan Mermin, director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, in a statement. “I have hope for innovative prevention tools – such as a pill after sex that prevents STIs, and better tests for syphilis – but they will only be successful if they reach the people who will benefit. And that is going to require coordinated and sustained efforts at the federal, state, and local levels.”

The U.S Department of Health and Human Services is also continuing to address the issue through the establishment of a federal task force last year.

“Addressing the resurgence of syphilis and congenital syphilis requires a concerted effort,” said Admiral Rachel Levine, assistant secretary for health and chair of the National Syphilis and Congenital Syphilis Syndemic Federal Task Force, in a statement. “We can collectively work towards reducing the incidence of syphilis and its devastating consequences, and we will turn the tide on the syphilis epidemic.”

Without the appropriate funding however, it’s difficult for communities to follow through with the recommendations by government officials, said Elizabeth Finley, director of communications at the National Coalition of STD Directors.

Over the past year, there has been a shortage of Bicillin, an antibiotic used to treat syphilis. In addition, last year states lost funding for STD prevention, affecting their ability to respond to syphilis.

“The 2022 data is devastating to see, but it’s already a year old,” said Finley. As a result, she said that “we have every reason to believe that the 2023 numbers will be much worse.”

The CDC report also included data on other sexually transmitted infections, stating that “reported gonorrhea cases declined for the first time in at least a decade while reported chlamydia cases were level.”

There were more than 2.5 million cases of syphilis, gonorrhea, and chlamydia reported in the U.S. in 2022 alone.

Without treatment, syphilis can cause serious health problems including damage to the heart and brain, and can cause blindness, deafness and paralysis. If transmitted during pregnancy, it can cause miscarriage, infant death and lifelong medical issues. With the right antibiotics, the STI is curable.


Additional Reading:

Syphilis Among Newborns Continues to Rise

Does Morning After Pill for STI Work?

Old Drug Offers New Stop for STI