In 1999, the Centers for Disease Control and Prevention (CDC) launched the National Campaign to Eliminate Syphilis from the United States. The CDC updated its ambitious plan in 2006 and aimed to reduce rates of primary and secondary syphilis to less than 2.2 cases per 100,000 population, congenital syphilis to less than 3.9 cases per 100,000, and the racial disparity between rates of syphilis among Black and White individuals to less than 3:1. Despite having moderate success at the turn of the century, the US is experiencing a drastic resurgence of syphilis. In 2021, the CDC reported 171,074 total cases of syphilis nationally, a 68.4% increase from 2017. Worse, there has been a sharp increase in the number of babies born with syphilis; cases of congenital syphilis rose 184.5% to 2,677 cases between 2017 and 2021.
Like other sexually transmitted infections (STIs), syphilis disparities remain with regards to gender, sexual orientation, and race/ethnicity. Syphilis disproportionately burdens men at five times the rate of women. Gay, bisexual, and other men who have sex with men made up nearly 40% of new syphilis cases in 2020 at a rate of 263.8 per 100,000 population. Additionally, communities of color—particularly Black/African American, Hispanic/Latino, and American Indian/Alaskan Native populations—report significantly higher rates of syphilis infection compared to their White counterparts.
The rising syphilis rates and disparities seen over the past two decades are reflected in the state of Ohio, where rates of syphilis in 2020 have increased by 45% from the previous year. Ohio’s most populated county, Franklin County, saw early syphilis rates double within the past decade. Additionally, Franklin County reported racial disparities in syphilis rates, as the rate among Black populations was 2.5 times that among white populations.
At AHF’s free walk-in HIV/STI testing clinics, known as Wellness Centers, anybody can receive comprehensive, cutting-edge testing for syphilis, as well as HIV, chlamydia, and gonorrhea.
Controlling the transmission of syphilis is imperative, as syphilis infections can lead to many other detrimental public health outcomes. Coinfection of HIV and syphilis are commonly reported, with studies and official data suggesting anywhere from 50-68% of individuals with syphilis being coinfected with HIV. Substantial evidence has demonstrated that syphilis infection can facilitate both HIV transmission and acquisition, and increase HIV incidence by two-fold. In one study, syphilis was shown to impact HIV parameters, such as increasing HIV viral loads and decreasing CD4 cell counts. Furthermore, one study found that the first six months following syphilis poses the greatest risk for HIV infection, highlighting the importance of early syphilis detection and treatment.
For 35 years, AIDS Healthcare Foundation (AHF) has engaged in public health prevention and advocacy surrounding syphilis because of its associated risks with HIV. At AHF’s free walk-in HIV/STI testing clinics, known as Wellness Centers, anybody can receive comprehensive, cutting-edge testing for syphilis, as well as HIV, chlamydia, and gonorrhea.
Wynette Collins, AHF’s Program Manager at the Columbus Wellness Center in Franklin County, stresses the value of syphilis testing in the community: “Syphilis infections have been rising across the board in Columbus. At our Wellness Center we find dozens of patients every month experiencing new syphilis infections. We treat all our patients, and even treat patients who get tested at other organizations when those sites don’t have the bicillin treatment available.” In 2022, Ms. Collins and her team tested more than two thousand Columbusites for syphilis and other STIs. “Our Columbus Wellness Center is open for free walk-in HIV/STI services on Mondays and Thursdays from 1:00PM to 6:00PM and Saturdays from 10:30AM to 2:00PM—everybody is welcome.”
AHF’s Associate Director of Mobilization Campaigns Latonya Thurman says that the Columbus Wellness Center and the dozens of Wellness Centers across the US are open for free prevention, testing, treatment, and linkage to care services: “We make ourselves available for HIV and STI referrals and provide only the best resources and information to our clients in a community-focused way. Grab our free condoms, get tested, and prevent the spread of syphilis and other STIs.”
We were poised to end syphilis decades ago. It is imperative that public health leaders double our investments to curb the rising syphilis epidemic. Not only will we reduce the morbidity and mortality of this infection, it will also reinforce our efforts to end the HIV epidemic.
This article was written by Adam Sukhija-Cohen, PhD, MPH, Director of Advocacy and Policy Research at AHF Public Health Division. Dr. Sukhija-Cohen can be reached at email@example.com.