DENVER — On Thursday, a Colorado public health order took effect that requires healthcare providers across the state to provide syphilis testing to pregnant people following a major increase in cases among newborns over the past several years.
Syphilis is a sexually transmitted infection (STI) that develops in stages and transmits by direct contact with a syphilis sore during vaginal, anal or oral sex, according to a fact sheet from the CDC. When passed on to the baby during pregnancy — known as congenital syphilis — it can cause defects and permanent disabilities, or death.
“What we know happens in congenital syphilis is that there's a really high mortality rate," said State Epidemiologist Rachel Herlihy. "In fact, about 40% of the time, when a person is pregnant, and their syphilis infection goes untreated, we see that case is fatal. So we see miscarriages, stillbirths, or death in the baby shortly after birth. We also see some longer term consequences in babies that do survive."
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Colorado to ramp up its syphilis response after ‘alarming increase’ in cases
Herlihy said Colorado health officials are continuing to monitor screenings and research what is behind the rise in cases. She said patients with syphilis may be asymptomatic, so making routine screenings is crucial to stopping the spread.
“Not just in the United States, but globally — we're seeing increases," she said. "And it's a really difficult problem to try to understand. But we do know from our data some of the risk factors that we see associated with the cases. So, we are seeing that there is a substantial number of cases that are associated with substance use. We're seeing cases that are associated with people that are experiencing homelessness. We see cases that are associated with individuals that have been in jail or correctional settings. But that doesn't explain all of the cases that we're seeing."
The state is recommending pregnant people receive three syphilis screenings during pregnancy: during the first trimester, third trimester and at the time of delivery.
TBD Health, a new sexual health clinic in Denver, began noticing a rise in cases months ago.
“We at TBD have seen people coming in with increased syphilis rates," said Stephanie Estey, co-founder and co-CEO of TBD Health. "A lot of times people are going months without even being tested."
Estey said TBD has noticed a variety of factors leading to the increase.
“A lot of times, STIs aren't emphasized in sex ed. There's so much related to not getting pregnant, but not really the importance of STI testing or what some of the implications can be," she said. "In addition, also how people are having sex is changing. So condom use has really decreased, particularly among younger populations, and all of that can lead to increases in STIs. Public health funds really shifted to COVID during the last few years, so there was a big emphasis on COVID. And that caused a lot of public health clinics to close and also just funding to be diverted to deal with COVID. That has really caused STIs to skyrocket. And it's almost this public health crisis that's bubbling under the surface that no one is really talking about today.”
Estey said TBD hopes to stop the spread by destigmatizing screenings and making screenings more accessible.
“We have built TBD all around making sexual health feel human or approachable and like something that you want to do," she said. "We have two clinics — one in Denver and one in Las Vegas —and also nationwide at-home STI screenings. TBD is completely cash pay. We have made it so that our prices are very affordable. So, the average five panel (test) is $150. That is significantly cheaper than what you would pay at either a local urgent care or a medical facility. In addition, we can also give you a super bill to submit to your insurance if you have insurance.”
Estey said the panel includes follow-up telehealth visits.
