A dramatic resurgence of syphilis in the United States is exposing stark racial and geographic health disparities, according to a new study published in BMC Infectious Diseases. Between 2018 and 2022, syphilis cases rose nearly 79%, with the highest rates found among American Indian/Alaska Native and Black/African American populations. In 2022, American Indian/Alaska Native individuals had nearly 18 times the odds of infection compared to White Americans, while Black/African Americans had seven times the odds.
The study also found that South Dakota, where American Indian/Alaska Native communities make up a significant portion of the population, reported the highest rates of syphilis nationwide. Researchers noted that these communities face persistent barriers to healthcare, including provider shortages and limited access to STI screening and treatment.
“Strengthening partnerships with Indigenous-led healthcare organizations” and expanding mobile clinics and telemedicine were among the recommendations to address these disparities. The authors emphasized that the rise in syphilis is not random but reflects “persistent health inequities shaped by geography, race, socioeconomic disadvantage, and behavioral health risks.”
High-risk sexual behaviors and substance use—especially methamphetamine and injection drug use—were also strongly linked to increased infection rates. The study calls for integrating STI prevention into harm reduction programs and culturally tailored public health campaigns to reach underserved populations.
See: “Epidemiological analysis of syphilis trends, disparities, and public health implications in the United States, 2018–2022” (September 5, 2025)
