By Lauren Weber, Kaiser Health News/MedPage Today
When Karolyn Schrage first heard about the “dominoes gang” in the health clinic she runs in Joplin, Missouri, she assumed it had to do with pizza.
Turns out it was a group of men in their 60s and 70s who held a standing game night — which included sex with one another. They showed up at her clinic infected with syphilis.
That has become Schrage’s new normal. Pregnant women, young men, and teens are all part of the rapidly growing number of syphilis patients coming to the Choices Medical Services clinic in the rural southwestern corner of the state. She can barely keep the antibiotic treatment for syphilis, penicillin G benzathine, stocked on her shelves.
Public health officials say rural counties across the Midwest and West are becoming the new battleground. While syphilis is still concentrated in cities such as San Francisco, Atlanta, and Las Vegas, its continued spread into places like Missouri, Iowa, Kansas, and Oklahoma creates a new set of challenges. Compared with urban hubs, rural populations tend to have less access to public health resources, less experience with syphilis, and less willingness to address it because of socially conservative views toward homosexuality and nonmarital sex.
In Missouri, the total number of syphilis patients has more than quadrupled since 2012 — jumping from 425 to 1,896 cases last year — according to a Kaiser Health News analysis of new state health data. Almost half of those are outside the major population centers and typical STD hot spots of Kansas City and St. Louis. Syphilis cases surged at least eightfold during that period in the rest of the state.