Name of the Student
DateAnalyzing the Social Determinants of Syphilis
Syphilis is a venereal disease and a chronic transmitted infection caused by the bacteria Treponema pallidum pallidum . The infection might be transferred from the mother to the child during pregnancy and also t may be transmitted sexually. The stage of syphilis include primary, secondary, latent and tertiary. The infection is managed by penicillin antibiotics. Untreated syphilis may lead to disease progression. Therefore it is important to detect and diagnose syphilis appropriately and in a timely manner (Clement et al 1905). The present article would try to evaluate the major social determinants that influence syphilis. The study would further evaluate the national policies in the prevention and management of syphilis.
Syphilis is strongly influenced by gender and the accessibility of health services in the United States. Men are a vital link in the spread of syphilis. It is noted that Men with Men (MSM) sex leads to a spread in syphilis. This is due to the nature of sexual activity involving the anal region. Due to such sex, the tissues in the anus get ruptured and the pathogen enters the blood stream of the opposite partner. Overall the prevalence of primary and secondary syphilis in Canada is accounted by men. Hence the major social determinant of syphilis is gender. The Center for Disease Control has speculated that incidences of syphilis are on the rise, and would reach vulnerable figure. Such rise in syphilis has been attributed due to the legalization of gay marriages and gay sex. Moreover, due to social stigma the diagnosis of syphilis in men becomes difficult. A data from United States in 2013 reflected that apart from the age group of 10-14 years, the incidences of syphilis across other age groups were primarily attributable to gay sex. In 2015, Alberta accounted for 80% of fresh cases of syphilis. Therefore, syphilis is a menace and is on the rise since 2000 (cdc.com).
A robust gender policy should be implemented for the screening purpose of syphilis in men. One such service has been initiated in Sanfrancisco and Amsterdam, where there is a online facility to ask for a requisition of blood tsting for syphilis, without the need of a medical recommendation. This policy is growing in popularity, because it is the first of its kind in preserving the confidentiality of the affected person and addresses the social stigma. However, policies should be made to ensure treatment of syphilis too. Therefore awareness on syphilis and its probable harms are still under projected across the vulnerable population. Certain regulations need to be ensured before gay marriages takes place. Both the partners should be mandatory checked for syphilis and should produce their status on syphilis, before legalizing marriages. Moreover, awareness of sex with the use of condoms must be propagated. Use of condoms and lubricant jellies will prevent erosion of the epithelium cells in the anus. This will prevent entry of the pathogen in the blood. Therefore increasing the awareness and increasing the testing facilities would lead to the control and spread of syphilis (Hawkes et al 684-691).
Accessibility to the healthcare facilities, remain another social determinant for the spread of syphilis. If a healthcare facility is not appropriately accessible, syphilis will remain undetected and untreated. This is because with a low awareness on syphilis and difficulty in accessing care facilities would combine and increase the prevalence of syphilis. The accessibility of health services are determined by the location of facilities and the abundance of facilities. The increased prevalence of syphilis in Canada itself by 10 times within fifteen years (1993 to 2000), indicates the failure of health services intervention in preventing the rise in syphilis (cdc.com).
The concept of a family physician is fast eroding all across the globe, and hence the day to day infections often do go unnoticed and silently resides in a human being. Syphilis is no exception and hence spreads silently. A conscious screening strategy needs to employ by various policy makers concerned with mass health. The concept of universal screening (irrespective of gender), may help to prevent the incidences of congenital syphilis. Since, the online requisition for blood testing has gained in popularity; syphilis testing and testing for other sexually transmitted diseases should be readily accessible to the general mass (Hawkes et al 684-691). In this case, the various pharmacies like Wal-Mart or Costco may be provided with syphilis testing facilities. Such initiatives must either be sponsored or subsidized by the Governments. Various studies have indicated that syphilis testing in non-clinical settings has been accepted with the overwhelming response. Perhaps one of the reasons is the mental stigma of presenting himself or herself to a clinician. Visit to a clinician is often viewed as a condition of ill health or a diseased state, and individuals are in fear of getting detected with other diseases or uncomfortable questions. However, with regard to screening only, individuals are more comfortable as they are not going to be questioned and they can take independent decisions regarding their diagnosis and treatment (Hogben S160-74).
Once the phase of diagnosis and detection gets over, the healthcare policy makers should implement safe and accessible medication for syphilis. It would be prudent to make certain antibiotics as over the counter sales, without the need of medical supervision. Moreover, there can be helpline numbers or “Ask a friend” kiosk in the pharmacies where a testing facility is provided, regarding the toleration profile of such antibiotics. The antibiotic policy should not be uniform and must be flexible, depending upon the resistance pattern of the Treponema bacterium and the sensitivity of antibiotics, prevailing at a point of time. With the success of pregnancy kits, “syphilis kits” may be introduced by the governments and health policy makers as early detection tools. Early detection of syphilis would help in the better eradication of the pathogen and decrease the virulence. For prevention of congenital syphilis, potent screening of pregnant women must be made mandatory in the first and the third trimesters. In fact in the United States, such provisions are already in place. However, developing countries that do not have a potent antennal screening may expose children to congenital syphilis. Physicians and other care providers must motivate one partner to get his or her counterpart screened for syphilis (Hogben S160-74). Such awareness programs must be initiated and especially in developing countries where there is almost no awareness on syphilis, or any other sexually transmitted diseases. The other health strategy that may be included in preventing syphilis is the mass awareness of the use of condoms in case of gay sex too (Koss, Dunne, & Warner 401-405).
Government policies and improvement of healthcare facilities in screening syphilis will help to prevent the growing incidences of syphilis. Finally mass awareness on hygienic factors and safe sex, will contribute to the final commitment of managing syphilis.
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Center for Disease Control and Prevention (CDC). “Syphilis-CDC fact sheet”. CDC. 1 March 2015, Accessed 29 November 2015.
Hawkes, S; Matin, N; Broutet, N;& Low, N. “Effectiveness of interventions to improve screening for syphilis in pregnancy: a systematic review and meta-analysis”. The Lancet infectious diseases, 2011,11(2):684–91.
Hogben, M. “Partner notification for sexually transmitted diseases”. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2007, 44(3) :S160–74.Print
Koss CA, Dunne EF, & Warner L. “A systematic review of epidemiologic studies assessing condom use and risk of syphilis”. Sex Transm Dis 2009,36(7) : 401–5.