TW: be aware that we will be discussing pregnancy, human trafficking and child death in this piece.
This week’s hot topic at the lunch table at HANX HQ? Trends in sexually transmitted infections (yes, we are considered a agitation at parties). Right now in the US, we are seeing an alarming increase in syphilis. It may sound like a Victorian disease, but cases of this sexually transmitted infection have increased by 80% since 2018 all age groups. When it comes to women’s health, it has a particularly devastating impact, especially on those who are pregnant. So why is this STD booming in all the States right now? HANX’s in-house OB/GYN and sexual health specialist, Dr Sarah Welsh, looks at the rise of syphilis, especially in women, and how to stay safe.
How do I know if I have syphilis?
Syphilis is transmitted primarily through vaginal, anal, or oral sexual activity without a prophylactic. One of the challenges in stopping the transmission of this sexually transmitted infection is that the symptoms of syphilis can be mild, change over time, and are often difficult to notice. Symptoms may include small, painless sores on the genitals, anus, or other areas, as well as flu-like symptoms, swollen glands, and a rash on the palms of the hands and soles of the feet. However, some people may experience no symptoms at all – and that’s a big problem. Without regular STD screening that includes syphilis (not all tests!), the lack of symptoms means it can go undetected, causing wider health complications for more people.
Why is treating syphilis so important?
If left untreated, syphilis can lead to serious or even life-threatening health problems, such as heart and brain damage, blindness, deafness, and paralysis. Although it doesn’t directly cause infertility in women the way gonorrhea or chlamydia can, syphilis increases the risk of miscarriage or stillbirth if you’re pregnant — and real risks for infants who contract it, too.
Why is syphilis on the rise in the US?
The rise of syphilis started massively in 2000 and continues to rise. In fact, a report from the Centers for Disease Control and Prevention shows a staggering 80% increase in diagnosis between 2018-2020. It is driven by a number of factors such as:
– lack of symptoms. When a growth, rash, or unusual discharge might prompt patients to seek medical attention, many people adopt a “no symptoms, no problem” mentality, leaving the condition undiagnosed, untreated, and ready to spread through sexual contact.
– dating app culture. This is not at all to demonize hookup culture. Dating apps offer increased sexual contact with a wider range of partners carries increased risk, especially if proper precautions are not taken to protect against STDs.
– lack of comprehensive sex education. We need to educate, empower and equip young people across the US to advocate for their sexual health. This is difficult in a country that does not have a national standard for sex education. In fact, 17 US states still provide abstinence-only sex education, and all boast higher than average teenage pregnancy rate. Open, honest and informed discussion about the dangers of unprotected sex has been proven to positive effect in the lives of young women.
– reduced condom use. Blame it partly on poor sex, but fewer Americans they use condoms beforehand. It has been suggested that this is not only due to abstinence-focused sex education, but also a growing stigma around condoms, for example, their impact on men’s sensitivity and pleasure.
– increased substance use/chemsex. Having sex while drunk or high on drugs is becoming increasingly normalized, but it can also remove inhibitions and increase the likelihood of risky behavior. This can make you more likely to make hasty decisions and not use barrier contraception such as condoms. For example, when it comes to an increase in syphilis in the US, the CDC has identified method abuse as a key factor.
– The most significant impact, however, is likely lack of funding for sexual health services. We will see below…
Why are women particularly affected?
When it comes to routine STD testing, many clinics are financially constrained in terms of the services they offer. Where sexual health screening is offered, syphilis is not always screened for and can essentially fly under the radar. This means that while some women are routinely tested for STIs during their annual exams, they are only clear for more common conditions such as gonorrhea or chlamydia.
In addition, some people are at higher risk for STDs (including women and people who exchange sex for drugs or money) they do not have access to proper health care, with many sexual health clinics having closed in recent years. While increased health care coverage may expand access to sexually transmitted disease care, locally, clinics simply close or reduction of basic services due to lack of budget. On a personal level, the cost of STD care in the US can also be largely prohibitive, turning away those who need treatment or preventive care. Similarly, many women who manage to access health care do not always complete treatment due to socioeconomic inequalities, lack of trust in the medical field, and human trafficking.
Pregnancy is a particularly vulnerable stage of life for women, especially when they will have syphilis. Declining access to antenatal care and prohibitive costs make it less likely to receive and treat syphilis – this was a key point of contact for diagnosis. Untreated, this can lead to congenital syphilis, where the infection is most often passed to the fetus in the womb or through direct contact with a syphilis sore in the vagina during childbirth. Sometimes, a healthy baby is born, but congenital syphilis can cause serious health problems, such as prematurity, miscarriage, stillbirth. It can also cause fever, meningitis in the first few days after birth and if not treated quickly, it can affect vision, hearing, cause developmental delays and more. Right now in the US, the CDC reports Seeing 1 case of congenital syphilis for every 357 births – creating a huge challenge for the health sector.
In essence, it’s a perfect storm: women are especially at risk because of a lack of comprehensive — and affordable — screening for STIs, poor sex education, partners who don’t get tested because of a lack of symptoms or stigma around STIs — and stigma around condoms , very.
How do we deal with the rise in STDs, including syphilis?
Without adequate funding, we made a steep climb to tackle the rise of syphilis. To combat this surge in cases, US health care experts are calling for a greater focus on prevention rather than mere treatment. This includes raising public awareness of the contamination by introducing multiple views for syphilis during pregnancy, making screening more affordable, better training health professionals and improving access to testing in institutions such as prisons. It is also important to address social inequalities that may contribute to the spread of sexually transmitted infections, such as active outreach, support and free resources for those most at risk of syphilis.
With the US election in full swing, Kamala Harris has made reproductive rights and affordable health care central to her campaign. As optimistic as we are, we think this could evolve to include more funding for public sexual health care – and actually help tackle the rise in syphilis, among other pressing sexual wellness issues.
So what can you do to protect yourself and others from syphilis?
- Get tested regularly for sexually transmitted infections, including asking for a syphilis test.
- Use barrier methods such as condomsduring sexual activity to reduce the risk of transmission.
- Practice open and honest communication with sexual partners about your sexual health and history.
By taking these steps and advocating for improved sexual health services, it is a start to reducing the spread of syphilis – and its impact on women’s health.
Do they want more?
- Do you have an STD? Here’s our practical guide on how to tell your partners.
- Get our sensitive ultra thin, FDA approved Condoms.
