Syphilis is at its highest levels since the 1950’s. Here's how experts are trying to fix that

Doctors and public health workers across the U.S. are racing to develop innovative and unconventional strategies to test and treat people for the infection.

Syphilis, a sexually transmitted infection, was nearly eliminated in the U.S. at the beginning of the 21st century but has made a dramatic comeback. In 2022, the Centers for Disease Control and Prevention reported more than 200,000 syphilis cases — the highest counts since 1950. Congenital syphilis has similarly increased tenfold over the past decade, the CDC says, even though 90% of cases are fully preventable.

The return of syphilis is the result, experts say, of poorly funded prevention programs over the past two decades and difficulties in diagnosis; syphilis is referred to as the “great imitator” because its symptoms can vary so widely. Most people don’t show symptoms or know they’re infected, and even if they do visit the doctor’s office, there’s no guarantee they’ll be properly diagnosed.

Stafford said her patient didn’t have the resources to seek prenatal care, and no doctor or public health worker had ever told her that she should get tested for syphilis. So, when the patient noticed a small rash on her belly, she didn’t think too much about it, Stafford added.

“There’s a lot of people who are seen in private practice, hospital ERs, or walk-in centers, and those clinicians are not necessarily thinking of syphilis, they’re not necessarily getting a sexual history,” said Dr. Kenneth Mayer, an infectious disease physician and medical research director of the Fenway Institute in Boston. With a generation of doctors who saw few, if any, syphilis cases during their training, Mayer said that “the issue is tests not being done in the first place.”

First cases of gonorrhea resistant to several classes of antibiotics identified in U.S.

Public health officials says they have found two cases of gonorrhea that appear to have reduced susceptibility to every kind of antibiotic available to treat them. It’s the first time strains of gonorrhea this resistant to antibiotics have been identified in the United States.



Increased sexual activity during the pandemic, coupled with fewer people getting routine health screenings, supercharged the spread of sexually transmitted infections around the world.

Those infections, including gonorrhea, are becoming increasingly resistant to antibiotics available to treat them, a problem that is becoming a dire threat to public health.

Globally, infections that are resistant to antibiotics kill approximately 700,000 people each year. That number is expected to rise to 10 million deaths per year by 2050 if steps aren’t taken to stop the spread of resistant organisms.

Experts say it was never a question of when this highly resistant gonorrhea strain would reach the US, but when.

“The concern is that this particular strain has been circulating around the world, so it was only a matter of time before it would hit the US,” says Dr. Jeffrey Klausner, a clinical professor of public health at the University of Southern California’s Keck School of Medicine in Los Angeles.

“It’s a reminder that gonorrhea is becoming increasingly resistant, increasingly hard to treat. We don’t have any new antibiotics. We haven’t had new antibiotics to treat gonorrhea for years and we really need a different treatment strategy,” said Klausner, who sits on the CDC workgroup for gonorrhea treatment.

Chlamydia Has Found A New Place To Hide

The bacteria that causes chlamydia, a common sexually transmitted infection, may lurk elsewhere in the body other than just the genitals.

Chlamydia trachomatis, the species of bacteria responsible for the STI, may hide out in our guts, according to a new study in the journal PLOS Pathogens.

These hidden bacteria may then migrate back to the genitals, and cause recurring infections.

This discovery could result in different types of antibiotics being prescribed for infections to truly eradicate all of the bacteria in the body, the researchers suggest.

Genital Herpes Is On The Rise. Here's What To Know About This Common Infection

The World Health Organization (WHO) recently released new estimates suggesting around 846 million people aged between 15 and 49 live with a genital herpes infection.



That’s equivalent to one in every five people from that age group.

At least one person each second (42 million people annually) contracts a new genital herpes infection.

So what is genital herpes, and are cases on the rise? Here’s what to know about this common infection.

How Do STD Tests Work?

Testing for sexually transmitted infections (STIs) can help keep you and your partners safe. Here’s what to know about who should test and when.

There are a number of different STIs, and specific variables — like your birth-assigned gender and sexual history — come into play when deciding which to get tested for.

Your primary health care provider or your local health clinic can also recommend specific testing by learning more about your sexual history and lifestyle.

You’ll likely be encouraged to test for one or more of the following:

• chlamydia
• gonorrhea
• HIV
• hepatitis B
• syphilis
• trichomoniasis

Your doctor probably won’t offer to test you for herpes unless you have a known exposure or ask for the test.

Most STIs can be detected through urine or blood samples. Depending on your sexual history, your health care provider may conduct a series of tests for STIs, which can also include swab tests. These can be performed on the mouth, vagina, penis, or anus, depending on the type of test necessary based on symptoms and sexual history.

FDA approves first at-home, over-the-counter test for STIs. But there's a catch

The at-home, over-the-counter test screens for chlamydia, gonorrhea and trichomoniasis.

The U.S. Food and Drug Administration (FDA) has approved the first-ever testing kit for sexually transmitted infections that can be taken at home without a prescription.

But it's not for everyone.

The FDA granted marketing authorization for the diagnostic test, the Visby Medical Women’s Sexual Health Test, to Visby Medical on Friday. The at-home kit, according to the FDA, is the first of its kind to test for chlamydia, gonorrhea and trichomoniasis, three of the most common STIs with symptoms that often go unnoticed.

The kit is intended for use in female patients with or without symptoms. It is single-use and includes a vaginal swab and a powered testing device that connects to the Visby Medical App. Results are displayed on the app about 30 minutes after testing.

Rape Kit: The History of How Activists Pushed to Include Evidence in Sexual Assault Cases

The new book The Secret History of the Rape Kit argues that our rape-kit evidence system — flawed as it may be — is a modern miracle.

Content warning: This article contains graphic descriptions of sexual assault and rape.



In the hours after a sexual assault, the survivor’s body is treated as a crime scene. For this reason, the survivor has the right to show up at a hospital and expect to be given a full forensic exam. A nurse will bring her into a room, open up a rape kit and pull out instructions, swabs, envelopes and other tools. The kit helps guide the nurse through what is typically a five-hour process of documenting the wounds on the survivor’s body and collecting DNA that could help to establish the identity of the attacker.

An FBI database stores the DNA information collected from thousands of kits – and can be used to reveal the path of a serial predator who has attacked a string of victims.

Our rape-kit evidence system is incredibly fragile and often falls short of its promise. And yet, it is a modern miracle.

While working on my book, The Secret History of the Rape Kit, I uncovered a hidden story of the 1970s activists who built this rape-kit system; they began their fight at a time when rape was often treated as an “unproveable” crime. So a revolution in forensics required more than technological advance. Anti-rape activists had to push for an entirely new idea: If you took the time to listen to the survivor and examine her wounds, her torn clothes and the fluids on her body, you could in fact prove that she had been assaulted. Evidence — like semen or skin cells — could be used to find out what had really happened.



To truly appreciate how far we’ve come, it’s important to understand not just the anti-rape movement of the 1970s but also the brutal pre-history of the modern evidence exam. For centuries, legal authorities performed “medical” tests on women’s bodies in order to judge the character of the victim herself. Was she a witch? An adulteress? A slut? A liar?

In this excerpt from the book, I recount that strange and disturbing pre-history.

Bacteria Transferred During Intercourse Could Help Identify Sexual Assault Perpetrators, Scientists Say

Genital microbiome or ‘sexome’ leaves specific signature even when barrier protection is used, which could be traced in absence of DNA material

Bacteria transferred between people during sexual intercourse could be used in forensic testing to help identify sexual assault perpetrators, an Australian study suggests.



Genital bacteria, similar to the microorganisms that make up the gut microbiome, vary between individuals. They are transferred to sexual partners during intercourse and leave specific signatures that can subsequently be detected, researchers found.

Study lead supervisor Dr Brendan Chapman, of Murdoch University, said the technique of tracing an individual’s sexual microbiome – or sexome, as the researchers have termed it – could eventually be used in sexual assault cases where no sperm is detected.

In Australia, 97% of sexual assault perpetrators are male, while one in five women over the age of 15 have experienced sexual assault.

“If there’s either no ejaculation, barrier contraceptive or a vasectomised male … that’s where this becomes really important as a potential second approach,” Chapman said.

The researchers homed in on a bacterial gene known as 16S rRNA, not present in humans. Its genetic sequence differs in bacteria found on different people.

Genital swabs from 12 monogamous, heterosexual couples before and after intercourse showed that a person’s bacterial signature could be identified on their partner after sex.

‘They’re just not enough’: Students push to improve sexual assault prevention for college men

A first-of-its-kind study from It’s On Us found that just 45 percent of college men receive sexual assault prevention training.

When Job Mayhue was a first-year student at the University of Michigan, both his girlfriend and best friend revealed within two weeks of each other that they had been sexually assaulted.

“I obviously knew that rape and sexual violence was an issue but had not had such clear proximity to it,” he said. “It hurts you different when it’s somebody that you know and love. I just was thinking, ‘I don’t want this to ever happen to anybody else.’”

Mayhue got involved with organizations that focus on sexual violence prevention, ultimately becoming a leader with It’s On Us, a national nonprofit program that works to support survivors and end college sexual assault.

Having recently served as chair of It’s On Us’ male-identifying student athletes caucus, Mayhue — who graduated in the spring — found that men on college campuses simply are not adequately informed about sexual violence and consent.