Is Drug Use Behind Rising Syphilis Rates?

By Maggie Ethridge 03/01/19
Syphilis rates have skyrocketed 156% for women from 2013 to 2017—and drug use may be making it worse.
woman being diagnosed with syphilis by her OBGYN

As public health officials grapple with the drug overdose crisis, they are also becoming alarmed at the increasing rate of syphilis diagnoses among heterosexual individuals.

Syphilis is a disease primarily transmitted through sexual activity. Experts say that infection rates have coincided with the use of meth and injection drugs like heroin.

The new Morbidity and Mortality Weekly Report published by the Centers for Disease Control and Prevention (CDC) analyzed national syphilis surveillance data covering 2013 to 2017.

The report gathered information from women, men who have sex with women only, and men who have had sex with men only, using the participants' reported drug use in the last 12 months.

The report found a large link between drug use and syphilis among women and heterosexual men. Women and men who reported the use of methamphetamine, heroin or injection drugs more than doubled from 2013 to 2017.

Those who had partners who used these drugs also had higher rates of syphilis. Over one-third of women and one-quarter of heterosexual men with syphilis reported to the researchers that they had used methamphetamine within the previous year.

This type of drug use makes people more likely to engage in risky behavior, such as not using condoms during sex, having multiple sex partners or exchanging sex for drugs and/or money, Sara Kennedy, medical director of Planned Parenthood Northern California, told BDN Health.

“Two major public health issues are colliding,” Sarah Kidd, a medical officer at the CDC and lead author of this new report, told BDN Health.

The syphilis diagnosis rate in the U.S. increased nearly two-fold from 2013 to 2014, with the highest diagnosis rates of 2017 among men who have sex with men.

Syphilis is treatable with antibiotics, but when left untreated it can lead to organ damage and possibly death. Congenital syphilis, when a mother passes the disease to her unborn baby, can lead to increased premature birth and death rate.

Antonio Urbina, MD, an associate professor of infectious disease at Mount Sinai Hospital in New York City, addressed the responsibility of doctors and the need for early diagnosis of syphilis.

“We need that type of care to be built into general primary care. I think providers often feel embarrassed about asking those questions. Or, they feel like they’re going to come across as judgmental. You know, it’s actually the opposite because I think patients appreciate you asking, and they want to tell. In that same regard, if somebody does screen positive for syphilis, I say, ‘Hey, this is what you have. We’re going to give you treatment. It’s important that you wait a certain period of time after your treatment before you resume any sexual activity so you don’t infect your loved ones or partners or any others.’ Then I ask them to identify their sexual partners and say, 'We need them to come in for a screening so we can offer them treatment as well.'”

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Maggie May Ethridge is the author of Atmospheric Disturbances: Scenes From a Marriage (Shebooks, 2014) and the recently completed novel, Agitate My Heart. She is a freelance writer published in Rolling Stone, VOX, Washington Post, The Guardian and many others. Find her at her blog Flux Capacitor or on LinkedIn or Twitter.