Syphilis Is Making a Comeback — Here's What You Need to Know
If you've seen recent headlines about syphilis, you might be wondering how a disease once considered nearly eliminated in the United States is suddenly back in the news. The truth is, syphilis never fully went away — and right now, it's surging at rates that public health experts are calling alarming. Understanding why this is happening and what you can do to protect yourself is more important than ever.
The Numbers Don't Lie: Syphilis Is Rising Fast
According to the Centers for Disease Control and Prevention (CDC), reported syphilis cases in the United States have increased dramatically over the past decade. In 2022, the CDC reported over 207,000 cases of syphilis across all stages — representing a 17% increase from the year prior and the highest number of cases recorded since 1950. This includes a deeply concerning rise in congenital syphilis (when a pregnant person passes the infection to their baby), which increased by 31% in a single year.
This isn't just a U.S. problem. The World Health Organization (WHO) estimates that approximately 7.1 million new syphilis infections occur globally each year among adults aged 15–49. The rise is being seen across many high-income countries, making this a worldwide public health concern.
So Why Is Syphilis Spreading?
There's no single reason for the surge. Several overlapping factors are driving the increase:
Declining Condom Use
Studies have shown a steady decline in consistent condom use, particularly among certain age groups and communities. The widespread availability of PrEP (pre-exposure prophylaxis), a medication that effectively prevents HIV, has been associated in some cases with reduced condom use — a phenomenon sometimes called "risk compensation." While PrEP is a major HIV prevention success story, it does not protect against syphilis or other STDs.
Cuts to Sexual Health Funding and Services
Public health infrastructure matters. Over the past decade, many local and state health departments have seen significant budget cuts to STD prevention and treatment programs. Fewer sexual health clinics, reduced outreach efforts, and strained contact tracing resources mean that infections are less likely to be caught and treated early — allowing the bacteria to spread further.
Reduced Testing and Awareness
Syphilis is sometimes called "the great imitator" because its symptoms can be mild, nonspecific, or even invisible. Many people who have syphilis don't know it. Without routine testing, infections go undetected and untreated — and continue to spread.
Social and Behavioral Factors
Increased use of dating apps has expanded sexual networks, which can accelerate the spread of STDs when testing and communication about sexual health don't keep pace. Social stigma around STDs also continues to discourage people from getting tested or talking openly with partners and healthcare providers.
What Exactly Is Syphilis?
Syphilis is a bacterial infection caused by Treponema pallidum. It spreads through direct contact with a syphilis sore (called a chancre) during vaginal, anal, or oral sex. It progresses through distinct stages:
- Primary syphilis: A single, painless sore appears at the site of infection. Because it's painless and may be hidden inside the body, many people never notice it.
- Secondary syphilis: A rash (often on the palms of the hands or soles of the feet), flu-like symptoms, and sores in the mouth or genitals may develop weeks later.
- Latent syphilis: Symptoms disappear, but the infection remains in the body. This stage can last for years with no symptoms at all.
- Tertiary syphilis: If left untreated for years, syphilis can cause serious damage to the heart, brain, and other organs — and can be life-threatening.
The good news? Syphilis is completely curable with antibiotics, most commonly penicillin, especially when caught in the early stages. Early treatment prevents long-term complications entirely.
Who Is Most Affected?
While syphilis can affect anyone who is sexually active, certain groups have been disproportionately impacted by the current surge:
- Gay, bisexual, and other men who have sex with men (MSM) continue to account for a significant proportion of cases, though rates are rising among heterosexual populations as well.
- Women of reproductive age are seeing some of the fastest increases, which is directly fueling the rise in congenital syphilis cases.
- Newborns are at serious risk — congenital syphilis can cause stillbirth, premature birth, and severe health complications for infants.
- Communities with limited access to healthcare, including rural populations and communities of color, are experiencing higher rates due to systemic barriers to testing and treatment.
What You Can Do to Protect Yourself
The rise in syphilis cases can feel discouraging, but there are clear, practical steps you can take to protect your health:
- Get tested regularly. If you are sexually active — especially with multiple partners or new partners — routine STD testing is one of the most important things you can do. The CDC recommends at least annual syphilis testing for sexually active MSM, and testing during every pregnancy.
- Use condoms consistently. Condoms significantly reduce the risk of syphilis transmission when used correctly every time.
- Talk to your partners. Having open conversations about STD testing and status isn't always easy, but it's a critical part of sexual health. You deserve that honesty, and so do your partners.
- Know the signs. Familiarize yourself with the symptoms of syphilis, but remember — many people have no symptoms at all. Don't rely on symptoms alone to determine your status.
- Seek treatment promptly. If you test positive, don't panic. Syphilis is treatable. Follow your healthcare provider's instructions, complete your treatment, and make sure any recent partners are notified so they can be tested too.
Breaking the Stigma Around Testing
One of the biggest barriers to controlling syphilis — and STDs in general — is stigma. People often feel shame or embarrassment about getting tested, which leads to delayed diagnoses and continued transmission. It's important to remember that getting tested is an act of self-care and responsibility, not something to be ashamed of. STDs are medical conditions, just like any other, and they deserve to be treated as such.
Take Action: Get Tested Today
The syphilis surge is real, but it is not unstoppable. Testing is the cornerstone of controlling this outbreak — and it has never been easier to access. Testing for syphilis is quick, simple, and widely available through your primary care provider, local sexual health or community health clinic, Planned Parenthood, or at-home testing services. Many clinics offer confidential or anonymous testing at low or no cost.
Don't wait for symptoms that may never come. Whether you've had one new partner or several, knowing your status is the single most empowering thing you can do for your sexual health. If it's been a while since your last test, today is a great day to schedule one.