AMERICAN SOCIAL HEALTH ASSOCIATION May 5, 1997
Contact: Sharon Broom, Director of Public Relations (919) 361-8416 [email protected]
ASHA: Apology for Tuskegee Study Does Not Signal End Of Syphilis in the South
Although rates of syphilis have declined nationally since 1990, they remain highest in Southern states. In some of the South's rural counties, the rate of syphilis in recent years has been as high as it was before the advent of penicillin as a cure for syphilis in the 1940s.
"The nation's apology to the surviving patients of the Tuskegee syphilis study does not close the door on syphilis in the South," said Peggy Clarke, president of the American Social Health Association.
"Syphilis has been virtually eliminated in almost all other Western industrialized nations and in many parts of this country," she said. "Yet it continues to plague the American South, especially among minorities." In the U.S., syphilis rates among African Americans are 60 times those among whites.
Clarke said public health experts believe an additional $10 million per year in federal spending - less than a 10 percent increase in the Centers for Disease Control and Prevention's appropriation for STD prevention - would go a long way toward eradicating syphilis throughout the U.S.
According to the CDC, of the 2,052 primary and secondary syphilis cases reported thus far in 1997, over three-fourths (1,589) occurred in 16 Southern states (Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, Oklahoma, North Carolina, South Carolina, Tennessee, Texas, Virginia and West Virginia). In 1995, the most recent year for which syphilis rates have been published, 12 of the 15 states with the highest syphilis rates were in the South.
Clarke said syphilis is more prevalent in Southern states because of the high concentration of low-income and rural populations, many of whom are minorities. "The lack of access to basic health care inhibits early and accurate diagnosis of syphilis, thereby accelerating the spread and intensity of the problem," said Clarke. "This situation is exacerbated in areas where drug use is prevalent, since sex is often exchanged for drugs."
Clarke said two factors make it increasingly urgent to stop the spread of syphilis: the impact of congenital syphilis on infants and the strong association between syphilis and HIV/AIDS. For pregnant women with untreated syphilis, the risk of infant death is 40 percent. Syphilis increases the risk of acquiring HIV/AIDS because syphilis lesions provide an entryway for the HIV virus.
"Prevention strategies that worked well in densely populated states have not proven effective in the largely-rural South," Clarke said. "Federal funding for the CDC's STD prevention programs is insufficient nationwide, but it is especially inadequate to address the high STD rates in Southern states."
In some Southern counties, public health clinics are only funded to operate a few hours each week, Clarke said. "When clients are repeatedly turned away, they may become discouraged and stop seeking treatment," she said. "And outreach efforts to identify and help those who do not know they are infected are hindered by inadequate resources."
Further, Clarke said, studies have indicated that many African Americans distrust health care initiatives that target their communities. Policy makers are faced with the challenge of increasing African Americans' level of participation in planning efforts for STD prevention.
Founded in 1914, ASHA is the only organization dedicated to stopping sexually transmitted diseases. Free, confidential information about syphilis and other STDs is available from the National STD Hotline, 800/227-8922.
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