Rising Syphilis in the United States: Epidemiological Trends, Disparities, and Behavioral Risk Factors

Syphilis has re-emerged as a significant public health concern in the United States, with reported cases rising steadily since 2018 and reaching levels not observed since the pre-antibiotic era. Despite growing awareness among healthcare providers and public health agencies, comprehensive epidemiological analyses of the populations most affected remain limited.

This retrospective descriptive study analyzed national syphilis surveillance data from the Centers for Disease Control and Prevention (CDC) between 2018 and 2022. Trends in syphilis incidence were evaluated across key demographic and behavioral variables, including race and ethnicity, geographic region, sex of sexual partner, and substance use behaviors. Findings reveal persistent and widening disparities, with disproportionate increases in syphilis rates among racial and ethnic minority populations, individuals reporting substance use, and across diverse geographic regions. These results underscore the urgent need for targeted, equity-focused public health interventions and evidence-based policy responses to mitigate the ongoing syphilis epidemic in the United States.