The city is sitting on a syphilis situation. Buried deep in a report released last month from a national health testing organization is the shocking statistic that San Francisco has the highest rate of syphilis infection of any county in the entire United States.
This report is a more detailed, regional breakdown of Centers for Disease Control data from 2017, displaying complete information on sexually transmitted infections (STIs) nationwide. It shows that San Francisco County has by far the highest prevalence of syphilis, with an infection rate more than double that of New York City — which lands at No. 5.
The San Francisco Department of Public Health’s sexual health clinic has more recent monthly data, and the truth is that our syphilis rate goes up and down from month to month. For example, it’s technically lower than it was this time last year. But San Francisco syphilis rates are still off the charts compared to other American counties, at levels that were unheard of 20 years ago.
“If you just look at the total number of cases, Los Angeles is much higher than we are,” explains Susan Philip, director of the Disease Prevention and Control Branch at the San Francisco’s Department of Public Health. “But our rates have been increasing over the past several years.
This is the same trend that has been seen throughout California, and throughout the United States, unfortunately.”
San Francisco syphilis infections had previously occurred primarily among gay and bisexual men, but that’s changing. Over the last five years, the syphilis rate among women in California has increased seven-fold.
And the symptoms are not pleasant. Syphilis can cause serious problems that go way beyond the bedroom. Untreated, it can cause blindness, paralysis, severe heart problems, and death, and it’s a scary, sneaky infection that can hide latently in your system for years with no apparent symptoms.
“Syphilis can be silent or it can manifest in ways that are not immediately clear that it is syphilis,” explains Phillips.
Luckily, you don’t need to worry about getting infected by toilet seats or a wayward sneeze. Syphilis is only transmitted through sex or prolonged kissing, and the infection is passed through direct contact with sores during vaginal, oral, anal sex, or the sharing of sex toys that may have been exposed.
It’s unrealistic to expect any San Franciscan to refrain from oral, anal, and vaginal sex. Instead, the sexually active should be vigilant about using condoms, female condoms, and dental dams.
Experts recommend getting an STD checkup every six months if you’re sexually active with more than one partner, and more frequently the more partners you have.
“For the groups that are most risk for syphilis in San Francisco, that includes gay men, men who have sex with other men, and transgender persons, we recommend screening every three months,” Philip tells us. “The testing for syphilis is a very simple blood test.”
The problem, though, is that most testing clinics in San Francisco do not offer syphilis detection among the infections and diseases they test for.
We found a few that do. SoMa’s San Francisco City Clinic offers free or low-cost syphilis testing on a drop-in basis, regardless of your insurance status. The Planned Parenthood Health Center on Valencia Street tests for syphilis among many other STDs, often for free or without a co-pay.
A few of our notable free clinics have new names, but still offer free or low-cost syphilis testing. Castro health center Strut, the successor clinic to the much-smaller Magnet, offers free syphilis testing, and accepts walk-in appointments. The Haight-Ashbury Free Clinics, now under the umbrella of HealthRIGHT 360, also continues to test for syphilis.
If you have the bad fortune of a syphilis infection, the good news is that it’s among the more easily treated infectious diseases. A regimen of penicillin shots — generally applied right to the buttocks — will usually offer a cure.
“Penicillin has been used for over 60 years for the treatment of syphilis,” Philip points out. Luckily, “the organism of syphilis has not developed any resistance to penicillin.”
Being the most syphilitic city in the country is nothing new to San Francisco: We had that same notorious distinction through much of the 1970s and ’80s, and over time, we drove the infection to near-extinction levels. And with some attention to safer sex and frequent testing, we can make the Sucka Free City a syphilis-free city again.