Over the last three years, the rate of syphilis infections reported in Miami-Dade and Broward counties has risen faster than the rest of the state and much of the nation — a troubling pattern that correlates with a spike in local HIV cases, leading local health officials to ramp up prevention and education efforts.
The two South Florida counties accounted for nearly 42 percent of the 5,340 syphilis cases reported in Florida from 2013-2015, according to the state health department.
Through June 2016, one Miami-Dade clinic has reported a dramatic spike in new cases among its adolescent patients.
“We have seen more cases in the first six months of this year as opposed to the last two years,” said Alex Moreno, clinical manager for the University of Miami Health System’s Promote to Protect program, which operates a testing site and a primary care clinic that focus on HIV-positive teens and young adults.
He said the program’s clinic logged 13 syphilis cases in 2015, and 12 so far this year.
Syphilis is curable with penicillin shots or pills, but it can be painful and, if not treated promptly, can cause long-term damage. And having syphilis, or any STD that causes a sore or break in the skin, makes it much easier to contract or transmit HIV — a particular concern for Moreno, who said many of the adolescents he works with live with the virus.
“We need to do more work with them,” he said, “so they're not spreading that disease and contracting another disease.”
Lori Jordahl, a sexually transmitted disease program consultant with the Florida Department of Health, said in an email that most syphilis infections are found among gay and bisexual men, and that more than 50 percent of these men are co-infected with HIV.
For that reason, local health officials are targeting men who have sex with men for special outreach, Jordahl said, noting the formation of the Miami Collaborative MSM Workgroup, which brings together healthcare professionals and academics to review data, share resources and strategically plan for ways to reduce infections in South Florida.
“America’s worsening STD epidemic is a clear call for better diagnoses, treatment and prevention efforts,” Jordahl said in the email.
Among 50 metropolitan areas included in the Centers for Disease Control and Prevention’s most recent report on STD surveillance, Miami-Fort Lauderdale had the nation’s fourth-highest rate of syphilis with 14.1 cases per 100,000 people — after New Orleans, Atlanta and San Francisco.
There is no single reason for the rise in syphilis infections, Jordahl said, noting that more cases may be diagnosed because of expanded testing. High risk behaviors and social stigma surrounding STDs and HIV also may lead some to ignore their status and expose others, she said.
As part of its prevention efforts, she said, the health department has contracted with more healthcare providers offering STD screenings, with a focus on gay and bisexual men. She said the department also is stepping up outreach and education efforts, and encouraging doctors and social service workers to get the message out.
In addition, a new rapid-testing tool will be available soon, allowing the department to act more quickly on prevention.