Monday, April 15, 2019

Syphilis spreading in rural U.S. because of intravenous drug use, stigma, lack of funding, and other factors

Rural counties across the Midwest and West are seeing a spike in syphilis. While the disease "is still concentrated in cities such as San Francisco, Atlanta and Las Vegas, its continued spread into places like Missouri, Iowa, Kansas and Oklahoma creates a new set of challenges," Lauren Weber reports for Kaiser Health News. "Compared with urban hubs, rural populations tend to have less access to public health resources, less experience with syphilis and less willingness to address it because of socially conservative views toward homosexuality and nonmarital sex."

How bad is the problem? In 1999 around 35,000 cases were reported, but by 2017 that number grew to 101,500, according to the Centers for Disease Control and Prevention, Weber reports.

Syphilis is easily treatable and curable with antibiotics, but can cause permanent brain damage, blindness, birth defects and/or death if left untreated. It's making a comeback partly because of increasing drug use, which often leads to risky sexual behavior. In rural areas, that's compounded by the stigma of seeking help for a sexually transmitted disease or reluctance to reveal homosexual activity. Another problem: Syphilis has been so rare until recent years that many health-care providers have never seen it in patients, and don't easily recognize it, Weber reports.

In 1999 the CDC had a plan to eradicate the disease in the U.S. by focusing on hotspots in the South, California, and major urban areas, "but health officials are losing the fight because of a combination of cuts in national and state health funding and crumbling public-health infrastructure," Weber reports. "Federal funding for STD prevention has stayed relatively flat since 2003, with $157.3 million allocated for fiscal year 2018. But that amounts to a nearly 40% decrease in purchasing power over that time, according to the National Coalition of STD Directors."

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