Congenital syphilis rates are going up here and across the country. But, Arizona is one of the states seeing the highest infection rates.
Today, it’s killing more than two dozen babies born in our state every year. And it’s totally preventable.
Dr. Karen Martinot is a board certified women’s health nurse practitioner as well as director of programs and clinical administration for the family planning nonprofit Affirm. She told The Show the rates here are alarming.
Full conversation
KAREN MARTINOT: We are seeing congenital syphilis rates going up by 200-300% in Arizona. We have not seen this in recent lifetime. So in the 1950s, we used to see syphilis rates being high. Then we had it almost completely gone where almost no one was getting syphilis, certainly not congenital syphilis in babies in Arizona.
And that changed around the year 2000, and we’ve seen a steady increase since then. Now we’re losing about 30 babies every year, dying to this completely preventable infection.
LAUREN GILGER: Wow. OK, and we’ll talk in a moment about what might have shifted around that time that changed the narrative here, but let’s back up for a moment and just talk about what congenital syphilis is. I think most people know that the sexually transmitted infection syphilis exists, but what makes it congenital?
KAREN MARTINOT: So we call it syphilis when it affects adults. When it affects babies, we call it congenital syphilis. That means syphilis that you’re born with. So that’s an infection that’s passed from the mother to the baby during pregnancy.
It’s a bacteria. So it’s a bacterial infection. We know how to test for it. We know how to treat it. It’s treated with penicillin, a form of penicillin injection for pregnant mothers. But it’s when we miss out on knowing who has it and the mother doesn’t get the treatment that babies can be born with this infection or die because of this infection.
LAUREN GILGER: Right, so syphilis is not an infection that would kill an adult, but it does kill babies sometimes.
KAREN MARTINOT: Exactly, so if syphilis is untreated in an infant, in a baby, during a pregnancy, 40% death rate. In adults, we have a lot of time. The progression of the illness is much, much slower in an adult person, so that gives us opportunities to get tested at our routine visits. But for pregnant people, they really need timely testing and timely treatment to prevent their baby from getting this infection.
LAUREN GILGER: So you said 30 deaths a year at this point. I mean, that’s a lot of babies. Is that an underestimate though? Do we know how many really?
KAREN MARTINOT: That is possibly an underestimate because we don’t calculate miscarriages from this infection. We know that this infection can harm babies in the beginning of pregnancy, cause preterm birth or stillbirth, or cause them to pass after they’re born.
LAUREN GILGER: So let’s talk about the why then, right? Like, you talked about having this STI nearly eradicated at one point, like people were not getting syphilis. What changed?
KAREN MARTINOT: So, sometimes when things are a little too good to be true, we think we don’t need to pay attention to them anymore. So folks that became healthcare providers back in late ’90s, early 2000s, they didn’t really receive a lot of training about syphilis or congenital syphilis, and it’s been sort of off our radar as something to routinely screen folks for.
It’s now squarely back on our radar, but the public hasn’t necessarily caught up with this. I think a lot of people are surprised to hear that babies are dying of syphilis in Arizona. I think they’re surprised to hear that they could be exposed to syphilis in Arizona.
This is a community-wide problem. It takes community-wide solutions to solve it, not just pregnancy-related solutions but all of us putting this on our radar so that adults are getting screened, men, women, all ages of folks that are sexually active should be screened.
That way we decrease the transmission of syphilis in adults. When we’re not doing that, eventually that goes to women of reproductive age and then therefore to babies.
LAUREN GILGER: So this is something you want to like, stem the tide right at the beginning, but I mean, it sounds like a lot of the prevention would be helpful during prenatal care, right? Is part of the problem here a lack of prenatal care for lots of folks?
KAREN MARTINOT: Absolutely. In the cases of babies with congenital syphilis, we see that the majority of them were born to mothers that had zero prenatal visits, and that’s just unacceptable.
But we have a shortage of OB/GYN providers and clinics. We also have some real-life barriers to getting into the clinic, and that includes things like folks experiencing homelessness and not knowing how they can access healthcare or get the care they need.
It’s also sometimes related to drug use. We know that we have a problem with substance use disorder in our country as well. There’s a lot of stigma around that. There’s also a lot of stigma around talking about sex in our country. You put those two things together, people are avoiding those conversations with their healthcare providers, so we need to help people feel safe to come in and to get the care they need so that they can get established with prenatal care.
LAUREN GILGER: Yeah, and lots of folks just not getting it to begin with. How does Arizona compare here to the rest of the country? Are we seeing higher rates?
KAREN MARTINOT: Yeah, unfortunately we’ve been in the top five for the last several years, and that’s not a distinction we want to continue.
LAUREN GILGER: What’s behind that? I mean, there’s got to be something specific happening in Arizona in terms of maybe access to care, funding for care, funding for Medicaid?
KAREN MARTINOT: Yeah, so Arizona does have less dollars going towards comprehensive family planning than other states. I work for Affirm, the grantee that supports those federal comprehensive family planning dollars to help folks in Arizona.
But a lot of other states have state-matched programs as well. Some of them even have additional funding from large philanthropic groups or other funders. So Arizona is vulnerable to the Title X funding to support these projects.
LAUREN GILGER: Right, so you are working for the organization that gives out those Title X funds, right? But without state matching, we’re falling short?
KAREN MARTINOT: Yes. We also see other funding at the federal level being reduced, so CDC offers STI testing funding. Those programmatic funds have also been decreased across the nation and to Arizona.
We’ve got wonderful folks meeting, convening, led by the Arizona Department of Health Services. We’ve got over 100 different organizations meeting regularly in a statewide steering committee. We’ve created a statewide work plan, but it’s hard to get those projects launched when we don’t have the funder backing behind them.
LAUREN GILGER: So we’re also looking at the federal level at big cuts to Medicaid coming as a result of the One Big Beautiful Bill, and those are coming in the next year or so here. Are we going to see a bigger impact here? Like could this potentially get worse as people lose coverage?
KAREN MARTINOT: Absolutely. So we know here in Arizona, we’ve got our AHCCCS, cost containment program, and they have recently responded to this positively by making sure that anyone with AHCCCS can get those testing and treatment reimbursed. That’s a great change.
But if people aren’t on the program, if people don’t know how to enroll or they get kicked off or there’s all these extra re-enrollment hurdles to get through — it’s not easy to navigate healthcare in general. When we put these additional barriers, even if people are eligible, they might not enroll because it’s being made more difficult for folks.
LAUREN GILGER: Dr. Karen Martinot, director of programs and clinical administration with Affirm, also a board-certified women’s health nurse practitioner, joining us. Dr. Martinot, thank you very much for coming in. I really appreciate you taking the time.
KAREN MARTINOT: Thank you for having me.
-
Arizona officials cut funding for a program that provides independent oversight at group homes for people with developmental disabilities, which was created in response to a sex abuse scandal. Advocates say the decision will harm the most vulnerable Arizonans. -
There were more than 2,000 confirmed cases of measles in the U.S. as of last week. That’s according to numbers from the Centers for Disease Control and Prevention and is only a couple hundred cases away from the total from all of last year. -
The measles outbreak connected to communities along the Arizona-Utah border has come to an end, according to public health officials. -
Advocates say a bipartisan state budget proposal doesn’t include funding for a program providing independent oversight at group homes for Arizonans with developmental disabilities that was created in the wake of a sex abuse scandal. -
An Orthodox Christian group is threatening to sue the city of Phoenix over a controversial new ordinance it passed last month that bans groups from providing medical care and food to the homeless in city parks — unless they have one of two permits that will be available for it per month in some parks.
