This Serious STI is Having a Resurgence in Rural America

In 1998, the Centers for Disease Control and Prevention launched a project to eliminate syphilis from the United States. Yet, two decades later, the sexually-transmitted infection (STI) is experiencing a resurgence. While treatable, syphilis is less well-known than other STIs. Its symptoms can be easily missed, and it can be fatal if untreated.

As you can see in data provided by the CDC, syphilis infection rates initially dropped in the late 90s. However, starting in 2007, infection rates rose when 40,925 cases were reported. In 2017, 101,567 cases were reported.

What is syphilis?

Anyone can catch syphilis through contacting a sore known as a chancre. Transmission is often through vaginal, anal, or oral sex, but you can be born with syphilis if your mother had it when she was pregnant. Sores aren’t always immediately visible, so you can catch syphilis without realizing.

Syphilis is divided into stages:

  1. Primary stage – a painless sore (or sores) appear at the site of infection, usually in the genital area or around the mouth. These sores are often firm and round and go away within 3-6 weeks regardless of whether the patient seeks treatment. However, if no treatment is given, the patient will progress to the next stage.
  2. Secondary stage – rash and mucous membrane lesions may appear in more than one area of the body. This rash is usually not itchy, and can be identified as rough, reddish spots on palms and bottoms of feet. Large, raised lesions that are gray or white can appear in the underarms, groin, and mouth. Swollen lymph glands, fever, sore throat, and hair loss are other symptoms. Secondary stage symptoms can be mild and missed.
  3. Latent stage – no signs or symptoms appear during this stage, but the bacteria still circulates within the patient’s body. Latent stage syphilis can last for many years.
  4. Tertiary stage – between 10 and 30 years after the initial infection, the tertiary stage can be experienced and can be fatal. Multiple organ systems, including the brain, eyes, and heart, can be damaged. Left untreated, tertiary stage syphilis can be fatal.

How is syphilis treated?

If diagnosed in a timely manner, syphilis can be effectively treated. Typical treatment is Benzathine penicillin injections. However, patients who are allergic to penicillin can ask their doctors about using doxycycline, tetracycline, or other antibiotics.

Treatment can be pricey. Patients can access substantially more affordable antibiotics through an online international or Canada drug center, which ships prescription drugs from licensed pharmacies located in countries with stricter drug price regulations. However, the best way to avoid the physical, psychological, and financial cost of syphilis is to avoid it.

Why is syphilis coming back in rural areas?

While most syphilis cases are still concentrated in urban places, public health officials are noticing a sizeable increase in cases among rural areas, reports Kaiser Health News. This may be attributed to several factors, most notably lack of access to medical care and socially conservative views.

The latter is noteworthy because syphilis seems especially prevalent among men who have sex with men (MSM). MSM in rural, socially conservative areas with minimal access to LGBTQ+-friendly doctors, or who need to keep their sexual orientation secret, can delay or even skip proper diagnosis and treatment.

How has technology affected all this?

Public health workers interviewed by Kaiser also noted that the digital age of dating apps may contribute to the rural syphilis rise. These apps allow people to find sexual partners with a few easy phone swipes, which may be convenient for rural Americans who find it hard to meet new people in person. Fleeting sexual partners can also remain anonymous, making it hard to track down possibly infected individuals.

Public health institutions have tried putting ads in apps like Grindr, encouraging people to get tested. However, they lack enough funding to do more.

What can I do to prevent syphilis?

Practicing safer sex can reduce the chances of you contracting syphilis. Knowing how to properly wear a condom helps, but sometimes, sores can be present in places outside the area covered by the condom. If in doubt, err on the safe side and abstain until the affected party gets a clean bill of health.

Meanwhile, get tested regularly if you are sexually active, and ask your partners about their status. Learn and understand the signs and symptoms of syphilis, and if you see a sore that might be a syphilis chancre, or if you’re feeling unwell, find healthcare right away.

No one should sacrifice their health needs for fear of discrimination. Rural Americans who have a hard time finding LGBTQ+-friendly health-care providers can access the CDC’s resources here.

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