Tennessee doctors hopeful new at-home syphilis test will slow rapid rise in STD cases

As syphilis rates rise at an alarming rate in Tennessee and across the nation, the U.S. Food and Drug Administration approved the first over-the-counter home syphilis test. While the test won't be available on a large scale until later this year, doctors in Tennessee remain optimistic about the impact it could have on sexually transmitted infection case numbers.

Tennessee's rate of newly diagnosed syphilis cases rose twice as fast as the national rate in the five years ending in 2022.

"Any sort of in-home testing for stigmatizing diseases is going to have a very large impact," Nashville CARES medical director Dr. Kassem Bourgi said. "Patients have not, for example, wanted to go to a doctor's office to get tested for something that sensitive, so the ability to do it from their home might be incredibly helpful."

Syphilis is a sexually transmitted infection that often does not result in any noticeable symptoms, but untreated over time, it can cause heart and brain damage, deafness and blindness, according to the Centers for Disease Control and Prevention .

However, if identified in the early stages, the infection can be completely cured with just 10 days of antibiotics like penicillin. When the at-home tests become available, patients who test positive will still need to seek care from a medical provider for treatment options.

Syphilis is diagnosed with a blood test and the at-home test requires a finger prick to draw blood.

"When appropriate, screening for STIs should be part of routine care if we really want to control syphilis," Bourgi said. "It gets a little bit muddy because this is not a topic a lot of patients want to talk about and not a topic a lot of physicians feel comfortable talking about."

Increase in Tennessee syphilis cases over five years: 162%

From 2017 to 2022, the number of syphilis cases in Tennessee increased 162% to 3,813, and cases in women specifically increased 311% to 1,191, according to data from the Tennessee Department of Health.

Another issue arising in the state is the over 400% rise in congenital syphilis cases, or babies born with syphilis.

“We are seeing babies with syphilis and syphilis exposure," Vanderbilt pediatrics professor Dr. Walter Dehority said in a statement. "Many infants born to women with untreated syphilis will require x-rays of the bones, an eye exam, a lumbar puncture and blood work just to evaluate for congenital syphilis infection, even if they are not treated."

Nationwide, syphilis cases increased by nearly 80% from 2018 and 2022, according to the CDC.

Potential impacts of decreased state health department funding

The Tennessee Department of Health cut funding for HIV prevention, detection and other treatments in May 2023 by rejecting nearly $9 million in federal CDC grant money that was previously distributed for HIV prevention-related services and STI testing. Instead, Gov. Bill Lee promised to replace the funds with state dollars to have more local control over the programs administered by nonprofits including United Way of Greater Nashville.

But, since the change occurred, the state health department has not released any comprehensive case numbers on sexually-transmitted disease infections and treatment.

While leaders across the state like Shelby County Mayor Lee Harris have criticized the decision to change funding sources for these programs, the direct impact on case numbers in Tennessee is yet to be seen.

"It's hard to tell exactly what's going to happen," Vanderbilt's VIVID Health Medical Director Dr. Chris Terndrup said. "Access to screening is great, which is why we should maintain excitement about the FDA approving additional options for screening, particularly for those that are less likely to access a provider. But in the end, no matter whether people are doing at home testing, they still need to have a provider for confirmatory testing, and they need to get access to treatment, which can be complicated."

Hadley Hitson covers trending business, dining and health care for The Tennessean. She can be reached at hhitson@gannett.com . To support her work, subscribe to The Tennessean .

This article originally appeared on Nashville Tennessean: Tennessee doctors hopeful new at-home syphilis test will slow rapid rise in STD cases