"CDC Reports Overall Decline in STIs Amid Rising Syphilis Cases in Newborns: A Dual Challenge in U.S. Public Health"

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The latest U.S. government data from 2024 reveal a complex picture for sexually transmitted infections (STIs): overall declines in common STIs among adults contrast sharply with the troubling rise of syphilis in newborns, underscoring critical public health challenges that remain.

CDC Reports Trends in STD Cases for 2024

Provisional data released by the Centers for Disease Control and Prevention (CDC) on September 23, 2025, show that the combined total of cases for the three most common STIs—chlamydia, gonorrhea, and syphilis—declined by 9% from 2023, continuing a positive trend for the third consecutive year. Specifically:

Chlamydia cases decreased by 8%, marking the second consecutive year of decline.
Gonorrhea cases fell nearly 10%, extending a three-year downward trend and returning below pre-pandemic levels.
Primary and secondary syphilis cases, the most contagious stages of the infection, dropped by 22% for the second consecutive year.

These reductions are credited to heightened public health efforts including expanded awareness, broader adoption of at-home and point-of-care STI testing technologies, and increased use of doxycycline post-exposure prophylaxis (doxy PEP) in high-risk groups such as men who have sex with men and transgender women. Dr. Bradley Stoner, Director of CDC’s Division of STD Prevention, emphasized:
“While the STI epidemic may be turning a corner, we must accelerate progress to eliminate its most tragic consequences. About 1 in 5 people in the U.S. have an STI, so continued commitment at all levels is essential.”

Alarming Rise in Congenital Syphilis

Despite overall improvements in adult STI rates, congenital syphilis—the transmission of syphilis from an infected mother to her newborn—persisted in its alarming upward trajectory in 2024. The CDC reported nearly 4,000 cases, a 2% increase from 2023, marking the 12th consecutive year of rising congenital syphilis cases. This rate reflects nearly a 700% increase since 2015, when fewer than 500 cases were recorded.

Congenital syphilis remains one of the most devastating outcomes of untreated maternal infection, leading to stillbirth, miscarriage, neonatal death, or lifelong disabilities in surviving infants. These disabilities can include vision and hearing loss, intellectual disability, skeletal deformities, and other severe health problems.

Elizabeth Finley, interim executive director of the Coalition of STD Directors, noted:
“The continued rise in congenital syphilis is a distressing indication that we are not doing enough to protect pregnant women and newborns from this deadly but preventable infection.”

Why the Discrepancy? Screening Gaps and Barriers

One key driver behind the rise in congenital syphilis is inadequate screening: only about 80% of pregnant women are tested for syphilis, leaving a significant fraction undiagnosed and untreated during pregnancy. Early detection through routine prenatal screening and timely antibiotic treatment can almost always prevent transmission and adverse outcomes.

Other potential contributing factors include disparities in access to prenatal care, social determinants of health such as poverty and healthcare inequities, and possibly regional variations in disease incidence that are not fully captured in national data.

Context and Public Health Implications

The broader U.S. STI epidemic remains a public health priority, with more than 2.2 million reported cases of chlamydia, gonorrhea, and syphilis in 2024—a figure still 13% higher than a decade ago. Although the recent declines among adults suggest that public health strategies, including education, prevention, and new treatment modalities, are gaining traction, the persistent climb in congenital syphilis serves as a stark reminder of uneven progress.

Healthcare professionals urge continued and expanded efforts in public health outreach, improved prenatal care coverage and screening standards, and greater investment in STI research and prevention tools. The use of doxycycline PEP, while effective in specific high-risk adult populations, does not address vertical transmission risks during pregnancy, underscoring the need for targeted maternal interventions.

Expert Perspectives

Dr. Jeffrey Klausner, infectious disease researcher at the University of Southern California, observes that some declines in STIs may be related to behavioral changes such as fewer new sexual partners among youth, but he warns this alone will not solve the epidemic without sustained prevention efforts. The CDC and its partners advocate for a multipronged approach, combining testing expansion, treatment access, and social support systems.

Limitations and Considerations

The data reported are provisional, and while the CDC does not anticipate major changes on final review, some regional or community-specific trends may differ from national patterns. Additionally, the stigma and disparities surrounding STIs may lead to underreporting in vulnerable populations, and ongoing surveillance is necessary to capture the true scope of disease burden.

What This Means for Individuals

For the general public, these findings reinforce the importance of regular STI testing, safer sex practices, and prenatal care screenings. Pregnant individuals should ensure timely syphilis screening and follow through with treatment if indicated. Awareness and access to new prevention tools such as home testing kits and doxycycline PEP can empower those at risk to take proactive steps.

Healthcare providers play an essential role in counseling patients, especially pregnant women, about risks, symptoms, and prevention. Public health agencies continue to work toward expanding these protective measures and addressing the social factors fueling the epidemic.

Medical Disclaimer

This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.