About
Health departments and healthcare providers can use county-level data of primary and secondary (P&S) syphilis to direct their screening efforts.
How to use these data
Understanding geography's role in syphilis risk
For many people, the most significant risk factor for syphilis is living in a community with high rates of syphilis. Considering geographic risk in addition to individual behaviors can help reduce stigma and bias in syphilis screening. This improves access to syphilis testing and treatment for everyone. Identifying and preventing syphilis before pregnancy can also help prevent congenital syphilis.
Healthcare providers
- Offer syphilis screening to sexually active people 15-44 years of age in counties with a high rate of syphilis* among women of reproductive age.
- Use the map and data table below to search for your county and scan to see if you should offer testing to this group.
*The Healthy People 2030 goal for reducing the rate of P&S syphilis among women aged 15–44 years is 4.6 per 100,000 people. This goal can provide a threshold for geography-based syphilis screening efforts for all sexually active people.
Other key actions
- If practicing in a county where the syphilis rate is below the 4.6 per 100,000 people threshold noted above, screen patients who are not pregnant for syphilis per other criteria, as specified in CDC Sexually Transmitted Infections Treatment Guidelines.
- Test—with rapid tests if necessary—everyone who is pregnant the first time you see them.
- Repeat syphilis testing during pregnancy for those living in counties with the highest rates of syphilis or those who are more likely to get syphilis during pregnancy.
- Treat syphilis immediately.
Health departments
- Know the burden in your jurisdiction: Use the map and data table below to identify counties in your states with high rates of syphilis and notify physicians in these counties to encourage more testing and coordinated treatment.
Other key actions
- Collaborate with community programs to address structural barriers to syphilis care, make testing (including rapid syphilis tests) and treatment more accessible, and link people to other needed services.
- Know the pregnancy status for people with syphilis to facilitate timely treatment. Verify that people with syphilis and their partners are treated.
County-level map of primary and secondary syphilis rates among women aged 15-44, 2023
County-level data table of primary and secondary syphilis rates among women aged 15–44, 2023
Data Table Footnotes
* In counties with a rate of primary & secondary syphilis among women aged 15–44 years at or below 4.6 per 100,000 people, providers should continue to assess individual risk factors to determine screening needs, as outlined in existing screening guidelines.
*Offer syphilis testing to all sexually active people aged 15–44 years in counties with a rate of primary & secondary syphilis among women aged 15–44 years that is greater than 4.6 per 100,000 people.
The data in the table above can be downloaded as an Excel file.