Earlier this year, the Centers for Disease Control and Prevention announced syphilis cases in the U.S. rose 80% between 2018 and 2022. Among the cases are an alarmingly high number of babies born with the disease.
A recent survey by The Ohio State University Wexner Medical Center may help to explain what’s behind the trend.
Dr. Jose Bazan is a professor of clinical internal medicine with the Division of Infectious Diseases at Ohio State.
Rand: Before we dig into the survey, can you first explain what syphilis is and why the data from the CDC is so alarming?
Dr. Bazan: Syphilis is a sexually-transmitted infection or an STI, that can really present with symptoms such as a whole-body rash, sores in the mouth or the genital area, and can have some short- and long-term complications, including things such as vision loss or hearing loss. We also know that unfortunately, STIs disproportionately affect gender or racial, ethnic and sexual minorities. And why the numbers are increasing really is a combination of many factors. We know that there's substantial societal disparities and inequities among at-risk patient populations, (including) things such as lack of health insurance, lack of transportation, unstable housing and others. And ultimately, all this adds up, you know, to an inability to access good inappropriate sexual health services.
Rand: The recent OSU survey found a little over a third of Americans wrongly believe that sexually transmitted infections like syphilis can only be spread through sexual intercourse. What's the reality?
Dr. Bazan: The majority of sexually-transmitted infections are still transmitted through sexual intercourse, and this includes practices such as oral-genital contact. Ultimately, the mode and risk of transmission depends on the specific STI that we may be talking about. But we also know that some of these STIs, for example, can have or end with ulcers and sores in the mouth or the tongue, and that could potentially pose a risk of transmission by oral contact.
Rand: What do you make of these misconceptions? Is there a clear reason?
Dr. Bazan: Well, some of it is likely, just say, either a lack of awareness or an under-recognition of specific at-risk behaviors. And all this ultimately can lead to ongoing transmission of STIs. So, we always encourage our patients to reach out to their health care providers to have these types of conversations.
Rand: What are some ways that folks should be taking charge of their sexual health to prevent STIs?
Dr. Bazan: Yeah, that's a great question. So, again, reaching out to health care providers to have these conversations that we really should be having—similarly to how we discuss other medical conditions—but also getting screened, specifically if patients have symptoms, they should reach out to their providers and get tested. But even in the absence of symptoms, if they have some at-risk behaviors, they certainly should go and get tested.
Rand: I know stigma can often be an issue as well for people seeking appropriate care. Can you talk about that?
Dr. Bazan: Stigma has been a barrier to sexual health care for a long time. And we really need to sort of break down those barriers. You know, we really need to create a safe and non-judgmental environment for our patients. That's the only way that we're going to have these honest conversations. And that's how we're going to really provide the best advice and care for our patients.
