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An analysis of surveillance data from January 2017–June 2025 in Washington’s King County area found a health clinic program that offered doxycycline post-exposure prophylaxis (doxy-PEP) starting in March 2023 was associated with substantial declines in syphilis diagnoses. Compared with projected trends, researchers found total cases decreased by 52.3% (3,031 fewer cases), as published in Clinical Infectious Diseases. Reductions were greatest among cisgender men (−53.1%; 2,248 fewer cases) but were also observed in cisgender women (−46.9%; 755 fewer cases) and transgender/nonbinary individuals (−33.1%; 56 fewer cases). On the downside, syphilis in pregnant people rose from 13 cases in 2017 to 48 in 2024, and congenital syphilis increased from 0 to 23 cases.
Shifting focus: The authors note the decline in the total number of syphilis cases has allowed disease intervention specialists to focus more on caring for pregnant women with syphilis who may have additional challenges such as homelessness or substance use disorders. Read more about syphilis testing from the JUCM archive: Missed Opportunities in STI Test Bundling