Dear USET/USET SPF Family,
Our commitment to supporting our USET member Tribal Nations includes providing resources and recommendations to reduce the prevalence of diseases in American Indian and Alaska Native (AI/AN) communities. One infectious disease we are currently monitoring is syphilis.
According to the Centers for Disease Control and Prevention (CDC), syphilis has been increasing across the country. Since 2015, syphilis infections have increased by 70%, classifying it as an epidemic. Due to this epidemic, AI/AN communities have been disproportionately impacted.
Raising awareness of this trend within the USET region is extremely important for the protection and prevention of the spread amongst Tribal Nation communities. Also, a proactive approach can help reduce negative health outcomes and increase awareness to encourage testing and treatment, if needed.
What is Syphilis?
Syphilis is a sexually transmitted infection (STI) spread by direct contact with a syphilis sore during vaginal, anal, or oral sex. Unless treated, this infection can result in serious health concerns, as it develops through the stages of primary, secondary, latent, and tertiary infection. Some signs and symptoms associated with syphilis include sores that appear firm, round, and painless, as well as rashes on the skin that do not itch, and other organ system complications if untreated.
The rate of primary and secondary syphilis among AI/AN (15.5 cases/100,000 population) was 2.6 times the rate among whites (6.0 cases/100,000 population) in 2018. More specifically, for AI/AN females, the rate was 5.4 times the rate of white females and for AI/AN males, the rate was 2.1 times the rate as white males.
What is Congenital Syphilis?
Congenital Syphilis occurs when a mother with untreated syphilis passes the infection to her baby during pregnancy. The timing of infection and treatment determines the impact on the baby.
Congenital syphilis increased by 500% among AI/AN from 2014 (13.2 cases/100,000 live births) to 2018 (79.2 cases/100,000 live births). This resulted in the rate for AI/AN cases (79.2 cases/100,000 live births) being 5.9 times the rate of whites (13.5 cases/100,00 live births) in 2018.
Indian Health Service National Clinical Recommendations:
- Screen everyone ages 13 to 64 annually for syphilis
- Turn on annual electronic health record reminders
- Perform three-point syphilis testing (prenatal, third trimester, & delivery) for pregnant people
- Adopt a testing bundle that includes Human Immunodeficiency Virus (HIV), Hepatitis B and C, and sexually transmitted infections at all sites
- Implement STI testing without a full clinical exam, known as “Express STI Testing”
- Screen outside hospitals and clinics (i.e.- community health fairs)
- Provide field treatment for syphilis among high-risk adults and their partners
- Treat syphilis presumptively for patients with a known exposure
- build awareness and encourage people to get tested and seek treatment
- AI/AN specific material can be found here for free:
Syphilis Resource Hub
Sample ToolKit for Express STI Resources
AI/AN Specific National Campaign Materials
To obtain additional resources, and recommendations, or to address any questions and concerns, please contact our USET Infectious Disease Program Manager, Gabbie Niski, at firstname.lastname@example.org.
Health Disparities in AI/AN
Syphilis Fact Sheet
Congenital Syphilis Fact Sheet
Dear Tribal Leader and Urban Indian Organization Leader Letter- IHS Syphilis Epidemic
Stop Syphilis Campaign
CDC: AI/AN Health Disparities