Syphilis Rates in Indian Country Are Rising and Our Relatives Deserve the Facts

Protecting Native health starts with honest conversation and timely information.

The Numbers Tell a Story Our Communities Cannot Ignore

Syphilis rates among American Indian and Alaska Native people increased from 21.1 per 100,000 in 2019 to 58.2 per 100,000 in 2023, representing a 116.3% increase between 2020 and 2023 alone. According to the National Council of Urban Indian Health, the AI/AN primary and secondary syphilis rate in 2023 was 3.7 times the national average and 6.4 times that of White counterparts. Congenital syphilis among AI/AN communities rose from approximately 200 per 100,000 live births in 2019 to 680.8 per 100,000 in 2023 — a 257.2% increase. AI/AN people represent just 0.7% of live births nationally yet account for 4.6% of all congenital syphilis cases.

Testing and Treatment Are Available Across Indian Country

The Indian Health Service recommends a three-point syphilis testing strategy for all pregnant women: at the first prenatal visit, the start of the third trimester, and at delivery. Treatment with penicillin during pregnancy is 98% effective at preventing congenital syphilis. The IHS Chief Medical Officer has called for annual syphilis testing for all sexually active individuals ages 13 to 64 at every service unit. Free, confidential home testing kits are also available through I Want The Kit, and Indian Country ECHO offers culturally competent clinical resources, patient education materials, and training for Native practitioners and community health workers. SAMHSA has also issued guidance supporting grant-funded syphilis response in behavioral health settings.

There Is Encouraging News Within the Data

Between 2022 and 2023, primary and secondary syphilis rates among AI/AN people decreased for the first time in several years, dropping from 67 to 58.2 per 100,000. This signals that culturally competent prevention efforts, expanded screening at IHS facilities, and community-driven awareness campaigns led by Indigenous organizations are making a measurable difference for Native populations. The Reproductive Health National Training Center provides additional clinical support tools for providers serving Our Relatives, including elders, families, and young people across Indian Country.

Ellsworth Stands With Our Relatives

As a Native owned small business and ISBEE-certified medical staffing company, Ellsworth shares this information with one purpose: to support the health and wellbeing of Indigenous communities. Knowledge is protection. If you or someone you care about has questions, please reach out to your local IHS facility, Urban Indian Organization, or tribal health program — and get tested today.