| On Tuesday, the Centers for Disease Control and Prevention announced some good news: Last year, the rates of primary and secondary syphilis, the most infectious stages of the disease, dropped more than they have in the past two decades. That's a relief for public health. Syphilis isn't easy to differentiate from other diseases, earning it the moniker "the great imitator." And while it's quite treatable in adults with antibiotics, it is often deadly for babies. In 2023, there were 279 stillbirths or infant deaths from the disease. Yet the new data offer hope. "I am encouraged, and it's been a long time since I've felt that way about STIs," says Jonathan Mermin, director of the CDC's National Center for HIV, Viral Hepatitis, STD, and TB Prevention. "I do feel we've reached an inflection point with the STI epidemic." The rate of primary and secondary syphilis dropped 11%, according to the data. Mermin says that the CDC's data doesn't explain why there was such a dramatic decrease, but he has some ideas. A growing number of people are getting pre-exposure prophylaxis, known as PrEP, to prevent HIV. Patients also get screened for other STIs as part of the treatment, leading to quicker diagnoses, Mermin says. On top of that, Mermin says, more people are taking the antibiotic doxycycline after being exposed to STIs, but before getting an official diagnosis. This practice, called "Doxy PEP," also might be pushing down rates of syphilis, since doxycycline kills the syphilis bacteria. And the mpox outbreak a few years ago caused some people who also might be at risk of spreading syphilis to modify their sexual behavior, Mermin says. It wasn't just good news about syphilis: Gonorrhea cases also dropped 7% from 2022 to 2023. While both improvements are significant, there's still more work to be done, since more than 2.4 million STI infections were reported across the US last year. "The impact of sexually transmitted infections remains severe," Mermin says. — Ike Swetlitz | 
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