IHS Provides Guidelines and Resources for IHS, Tribal, and Urban Indian Healthcare Facilities on Combating the Syphilis Epidemic

On July 19, 2023, Indian Health Service (IHS) released a Dear Urban Leader Letter detailing the current syphilis epidemic impacting American Indian and Alaska Native (AI/AN) communities. AI/AN people have the highest rates of syphilis, which has serious consequences including congenital cases that are linked to stillbirths or infant death occurring shortly after birth. To combat this epidemic, IHS has introduced several guidelines and resources recommended for all IHS, Tribal, and urban Indian organizations (UIOs) healthcare facilities system including:

  • Annual syphilis testing
  • Three-point syphilis testing for all pregnant people
  • Enhance screening rates by screening outside of hospitals and clinics
  • Presumptive treatment of syphilis
  • Create and build awareness and encourage people to get tested and treated


A recent surge in syphilis cases has significantly impacted and affected Indian Country. Given that American Indian and Alaska Native people have highest primary and secondary syphilis rates in the country, it is vital that health care providers and educational campaigns work together to reduce the prevalence of syphilis and other sexually transmitted infections (STIs). Prevention education and outreach can significantly reduce the health disparities caused by syphilis. For more information regarding syphilis prevention and education, Syphilis Resource Hub offers up to date and in-depth trainings and strategies regarding disease control and prevention.

NCUIH’s Role

The National Council of Urban Indian Health (NCUIH) proactively monitors the impact of diseases effecting Indian Country. As part of this effort, NCUIH regularly hosts panels and webinars to keep UIOs and other stakeholders informed about current trends or best practices pertaining to disease control and prevention education. For example, on June 21, 2023, NCUIH hosted an online webinar Strengthening Syphilis Care in Indian Country aimed to tackle challenges, share innovative solutions, and pave the way for enhanced syphilis and other STI services and capacities for UIOs and Americans Indians and Alaska Native people. NCUIH will continue to advocate and monitor for the resources needed to reduce health disparities for American Indian and Alaska Native people regardless of where they live.

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