Syphilis incidence continues to rise substantially among men who have sex with men (MSM), people living with HIV (PLWH), newborns, and women of reproductive age, despite preventive measures and available treatments. A major contributing factor is the increasing antimicrobial resistance, which complicates current therapeutic strategies for syphilis. This study aims to support the development of evidence-based, targeted interventions designed to address the specific needs of high-risk populations and to minimize the risk of antimicrobial resistance, while contributing to the overall reduction of syphilis infections. To expand our analysis, we obtained data from the Centers for Disease Control and Prevention (CDC) spanning 2020-2024 through the National Notifiable Sexually Transmitted Infections Surveillance System in the United States to evaluate the trends in syphilis. We also conducted a comprehensive literature search across multiple databases and identified additional epidemiological evidence. Our findings indicate that the incidence of syphilis cases is projected to increase in North America, Europe, and Asia. Although there was a significant decrease in cases of primary and secondary syphilis globally in 2024 compared with 2023, there was an increase in late and congenital syphilis cases over a longer period from 2020 to 2024. Furthermore, the complex interaction between HIV and syphilis appears to contribute to a heightened risk, which poses challenges for infection control and effective treatment. The rising trend of syphilis remains a global threat, thus requiring multilevel public health interventions, including strengthening education, increasing routine testing, ensuring appropriate antibiotic prescribing practices, and promoting early treatment to prevent transmission. Furthermore, to address the rising cases of syphilis, the availability of additional treatment options and the development of vaccines are crucial strategies for strengthening public health protection.
Habiya et al. (Wed,) studied this question.
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