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July 6, 2023
Dear Health Resources and Services Administration Recipient Colleagues:
This letter is to inform Health Resources and Services Administration (HRSA) recipients of the increasing syphilis rates within American Indian/Alaskan Native (AI/AN) communities. In partnership with the Indian Health Service (IHS), HRSA specifically notes the escalating rates of syphilis within highly impacted jurisdictions in Alaska, Arizona, Montana, Nebraska, New Mexico, Oregon, and South Dakota. Given the reach of HRSA programs and services across impacted communities, this letter is a request to utilize the Centers for Disease Control and Prevention (CDC) sexually transmitted infections (STIs) screening and treatment guidelines to address this serious issue among AI/AN communities. This letter also includes the IHS Field Treatment Guidelines sent to IHS partners (see attachment (PDF)).
Nationally, CDC data indicate that the rate of primary and secondary syphilis among AI/AN in 2021 was 42.2 per 100,000 (nearly 5 times that of white individuals), up 520 percent from 8.0 per 100,000 among AI/AN in 2016. In the same time period, congenital syphilis has increased over 900 percent among AI/AN (rate of 37.7 per 100,000 live births in 2016 compared to 363.7 in 2021) and is almost 10 times higher than whites.
HRSA recommends that recipients and subrecipients adopt the CDC recommendation for universal screening and testing for at-risk populations and follow their local and state testing and treatment guidelines for syphilis and other STIs.
As always, thank you for your ongoing commitment and dedication to support the prevention, care, and treatment needs of people across the country.
Sincerely,
/Laura W. Cheever/ /Antigone Dempsey/
Laura Cheever, MD, ScM. MEd. Antigone Dempsey,
Associate Administrator Associate Administrator
HIV/AIDS Bureau Office of Intergovernmental & External Affairs
/James Macrae/ /Tom Morris/
James Macrae, M.A., M.P.P. Tom Morris, MPA.
Associate Administrator Associate Administrator
Bureau of Primary Health Care Federal Office for Rural Health Policy
/Michael Warren/
Michael Warren, MD., MPH., FAAP.
Associate Administrator
Maternal and Child Health Bureau
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