PHILADELPHIA – Syphilis cases are on the rise around the globe, but many Americans don't know the symptoms.
In January, the Centers for Disease Control and Prevention (CDC) reported that syphilis cases had risen 80 percent over the five years from 2018 to 2022, totaling more than 200,000 in 2022, the last year for which data are available.
Yet just over half of U.S. adults (54%) know that a case of syphilis can be permanently cured and most either mistakenly think there is a vaccine to prevent it (16%) or are unsure (45%), according to the Annenberg Public Policy Center's new survey findings on sexually transmitted infections (STIs). The survey of U.S. adults finds that many are familiar with some ways they can protect themselves from syphilis but lack familiarity with its symptoms and signs.
The survey also finds areas of uncertainty about other STIs, including whether they can be cured and whether vaccines exist. Only a third of the public knows that HPV (human papillomavirus) cannot be permanently cured and a third of the public does not know there is a vaccine to prevent it. (The CDC reports that the HPV vaccine has the potential to prevent more than 90% of HPV-attributable cancers.) Two years after a global outbreak of mpox, formerly called monkeypox, most people do not know whether it can be cured (it can be) or whether a vaccine exists (it does).
"With the rising number of syphilis cases, knowing the causes, symptoms, and treatment for it assumes added importance," said Kathleen Hall Jamieson, director of the Annenberg Public Policy Center (APPC) of the University of Pennsylvania.
APPC's latest Annenberg Science and Public Health (ASAPH) Knowledge survey, conducted from April 18-24, 2024, questioned a national probability sample of over 1,500 empaneled U.S. adults about their knowledge about sexually transmitted infections, with more extensive questions about knowledge and treatment of syphilis and HIV. See the survey toplines.
Protecting oneself from contracting syphilis
What people do know: When asked to select which, among the following, are ways that individuals can protect themselves from contracting syphilis, most people got the answers right – selecting the correct ways and skipping the wrong answers:
- 78% correctly chose abstinence, or not engaging in sex
- 77% correctly chose using a condom
- 94% correctly did NOT select oral contraception (the pill)
- 89% correctly did NOT select wearing a diaphragm
- 78% correctly did NOT choose getting a vaccine (there is none)
But 71% did not select using only clean needles, which is one of the ways to protect oneself from contracting syphilis.
Failing to recognize symptoms of syphilis
What people don't know: When asked to select usual syphilis signs and symptoms from a list, less than a third of survey respondents selected any of these symptoms (according to the CDC, all are symptoms of types of syphilis:
- 30% selected "firm, round, painless sores"
- 28% selected "swollen lymph nodes"
- 27% selected "fever"
- 16% selected "weight loss"
- 13% selected "dizziness or lightheadedness" [the CDC says it's a sign of otosyphilis]
- 12% selected "blurry vision" [the CDC says it's a sign of ocular syphilis]
How can HIV be spread?
The survey finds that U.S. adults are generally knowledgeable about how HIV (human immunodeficiency virus) can be spread. Asked to select from a list which of these methods are ways in which HIV can be spread:
- 95% know HIV can be spread through unprotected sex
- 90% know HIV can be spread by sharing needles
- 67% know HIV can be spread from an infected person to their child while giving birth
Respondents also know that the following means are not ways in which HIV can be spread:
- 89% correctly did NOT select by exposure to airborne droplets that are coughed or sneezed into the air by an infected person.
- 88% correctly did NOT select from touching a surface contaminated by the virus
- 85% correctly did NOT select by using the "party drugs" known as poppers
However, only 1 in 3 adults (33%) knows that HIV can also be spread from an infected parent breastfeeding a child.
How can you get an STI?
The survey finds that U.S. adults are generally familiar with how you can get an STI. Asked to select from which of the following activities you can get an STI:
- 98% know you can get it from vaginal sex
- 89% know you can get it from oral sex
- 93% know you can get it from anal sex
