Syphilis Rate Declines among African Americans

December 5, 2000

Syphilis Elimination Update: Syphilis Rate Declines among African Americans

Promising Sign for CDC Campaign to Eliminate Syphilis in U.S.

MILWAUKEE - The syphilis rate among African Americans declined 29 percent between 1997 and 1999, helping to bring the overall syphilis rate in the United States to a record low, according to a new report released today by the Centers for Disease Control and Prevention (CDC).

The statistics on syphilis and other STDs are included in CDC's biennial report, "Tracking the Hidden Epidemics: Trends in STDs in the United States," released at the National STD Prevention Conference being held Dec. 4 to 7 in Milwaukee.

"Although I am encouraged by the continued decline in the syphilis rate among African Americans, the fight against this health threat must continue," said CDC Director Jeffrey P. Koplan, M.D., M.P.H. "We must continue to expand access to health care and awareness about syphilis in African American communities."

Compared to other racial and ethnic groups, African Americans are disproportionately affected by syphilis. Reported rates of primary and secondary (P & S) syphilis in 1999 are 30 times higher for African Americans than for white Americans. Race and ethnicity itself is not a risk factor for syphilis and other STDs, however, many important factors contribute to higher rates of STDs among African Americans, including poverty, less access to quality health care, and higher rates of substance abuse. Also, prevention outreach efforts for STDs in some communities may not yet be a high priority.

The recent decline in P & S syphilis among African Americans has helped to bring the overall syphilis rate in the United States to its lowest level since reporting began in 1941. The P & S syphilis rate was 2.5 cases per 100,000 people in 1999, an 88 percent decline from the most recent peak of 20.3 cases per 100,000 people in 1990. The overall rate of congenital syphilis declined 50 percent, with rates falling from 27.7 in 1997 to 14.3 per 100,000 live births in 1999.The new low in the syphilis rates is an important advance for CDC's National Campaign to Eliminate Syphilis in the United States, officially launched in October 1999.

"Now that the syphilis rate has reached a record low, our prospects for eliminating the disease in the United States have never been greater," said Koplan. "I look forward to adding syphilis to the list of diseases that have been eliminated in this country."

Syphilis elimination can improve infant health, slow the spread of HIV infection, and reduce racial disparities in health. Untreated syphilis during pregnancy results in infant death in up to 40 percent of cases, and nearly two-thirds of cases of congenital syphilis are among African Americans. Moreover, syphilis accelerates the spread of the HIV epidemic. The presence of syphilis increases the chances of both acquiring and spreading HIV infection at least two- to five-fold.

George W. Counts, MD, director of CDC's Syphilis Elimination Program, cautioned that, without increased efforts to eliminate syphilis, rates of the disease would almost certainly rise again. After syphilis was nearly eliminated in 1957, rates of the disease rebounded - a pattern that has been repeated every seven to ten years.

"We have a brief window of opportunity to eliminate this disease," said Counts. "We must not allow complacency to let this chance slip from our grasp."

Counts also noted that, in contrast to the recent progress made among African Americans, primary and secondary syphilis rates among whites and Hispanics did not decline from 1997 to 1999. During this period, primary and secondary syphilis rates were stable for white Americans and increased 20 percent in Hispanics. The increase in Hispanic rates occurred primarily among men.

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The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national and international organizations.

CDC's STD Program provides national leadership through research, policy development, and support of effective services to prevent all sexually transmitted diseases and their complications. To accomplish this goal, CDC provides funding and guidance to state and local public health departments and community based organizations to track the course of STD epidemics, raise awareness of STDs, and to design, implement, and evaluate prevention and treatment programs.