The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.
SMJ // Article
Original Article
Relationship between the Prevalence of Syphilis and COVID-19 in Lubbock County and Texas
Abstract
Objectives: This study aimed to evaluate the trends in syphilis prevalence in Lubbock County, Texas, from 2018 to 2022 and identify significant changes over time. In addition, it sought to assess the relationship between syphilis trends and the coronavirus disease 2019 (COVID-19) pandemic, comparing local patterns to state-level data.Methods: Data on COVID-19 cases in Lubbock County and Texas from 2018–2022 were obtained from the City of Lubbock Health Department and the Texas Department of State Health Services. Joinpoint regression analysis was conducted to identify statistically significant changes in the linear trends of the prevalence of syphilis and COVID-19 over time and evaluate disparities in these temporal trends.
Results: There were significant changes in the growth of the number of syphilis cases that coincided with increasing trends in COVID-19. The growth in the trend for these two infections was largely parallel. A similar relationship between syphilis and COVID-19 was observed for the state of Texas, although the growth in the trends of syphilis from 2020 to 2022 was higher in Lubbock County than the growth for Texas.
Conclusions: The data indicate a notable relationship between the growth in the prevalence of syphilis and COVID-19 in Lubbock County and Texas from 2018 to 2022, with estimates for Lubbock County being more pronounced than Texas.
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References
1. Centers for Disease Control and Prevention. Sexually transmitted infection surveillance 2022. https://www.cdc.gov/sti-statistics/media/pdfs/2024/11/2022-STI-Surveillance-Report-PDF.pdf. Accessed November 25, 2024.
2. Qin J, Yang T, Xiao S, et al. Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis. PLoS One 2014;9:e102203.
3. Payne JD, Derrick W, Wells K. Texas accounts for 25% of national congenital syphilis cases in 2022. Southwest Respir Crit Care Chron 2024;12:1–2.
4. Graves LL. Lubbock County: history, geography, and agriculture. https://www.tshaonline.org/handbook/entries/lubbock-county. Published 1952. Accessed August 18, 2024.
5. Holtgrave DR, Crosby RA. Social capital, poverty, and income inequality as predictors of gonorrhoea, syphilis, chlamydia and AIDS case rates in the United States. Sex Transm Infec 2003;79:62–64.
6. US Census Bureau. Lubbock County, Texas. United States Census Bureau. https://data.census.gov/profile/Lubbock_County,_Texas?g+=+050XX00US48303&g=010XX00US. Accessed August 18, 2024. .
7. US Census Bureau. Texas. https://data.census.gov/profile/Texas?g=040XX00US48. Accessed August 18, 2024.
8. National Coalition of STD Directors. Covid-19 and the state of the STD field phase III. https://ncsddc.org/resource/covid-19-and-the-state-of-the-std-field-phase-iii/. Published January 28, 2021. Accessed August 22, 2024.
9. Cejtin HE, Warren EF, Guidry T, et al. Notes from the field: diagnosis of congenital syphilis and syphilis among females of reproductive age before and during the covid-19 pandemic — Chicago, 2015–2022. MMWR Morb Mortal Wkly Rep 2023;72:1288–1289.
10. Centers for Disease Control and Prevention, National Notifiable Diseases Surveillance System. Syphilis (Treponema pallidum) 2018 case definition. https://ndc.services.cdc.gov/case-definitions/syphilis-2018/. Published April 16, 2021. Accessed April 6, 2025.
11. Texas Department of State Health Services. Texas STD surveillance report. 2022 annual report. https://www.dshs.texas.gov/sites/default/files/hivstd/reports/STDSurveillanceReport.pdf. Published 2023. Accessed August 18, 2024.
12. Texas Department of State Health Services. Historical Texas COVID-19 data. https://www.dshs.texas.gov/covid-19-coronavirus-disease-2019/texas-covid-19-data. Accessed August 18, 2024.
13. US Census Bureau. County population totals and components of change: 2020-2023. https://www.census.gov/data/tables/time-series/demo/popest/2020s-counties-total.html. Published 2024. Accessed August 18, 2024.
14. US Census Bureau. National population totals and components of change: 2020-2023.
https://www.census.gov/data/tables/time-series/demo/popest/2020s-national-total.html. Published 2024. Accessed August 18, 2024.
15. US Census Bureau. County population totals: 2010-2020. https://www.census.gov/programs-surveys/popest/technical-documentation/research/evaluation-estimates/2020-evaluation-estimates/2010s-counties-total.html. Published 2021. Accessed November 12, 2025.
16. US Census Bureau. National population totals and components of change: 2010-2019.
https://www.census.gov/data/tables/time-series/demo/popest/2010s-national-total.html. Published 2021. Accessed August 18, 2024.
17. Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 2000;19:335–351.
18. Nagendra G, Carnevale C, Neu N, et al. The potential impact and availability of sexual health services during the COVID-19 pandemic. Sex Transm Dis 2020;47:434–436.
19. Tao J, Napoleon SC, Maynard MA, et al. Impact of the COVID-19 pandemic on sexually transmitted infection clinic visits. Sex Transm Dis. 2021;48:e5–e7.
20. Texas Department of State Health Services. 2023 congenital syphilis report. https://www.dshs.texas.gov/sites/default/files/legislative/2022-Reports/2023-Congenital-Syphilis-Report.pdf. Published 2023. Accessed April 24, 2025.
21. Wright SS, Kreisel KM, Hitt JC, et al. Impact of the COVID-19 pandemic on Centers for Disease Control and Prevention-funded sexually transmitted disease programs. Sex Transm Dis 2022;49:e61–e63.
22. Jenks JD, Nipp E, Tadikonda A, et al. Relationship between sexually transmitted infections and social determinants of health in Durham County, North Carolina, United States. Open Forum Infect Dis 2023;10:ofad368.
23. American Hospital Association. Task Force on Ensuring Access in Vulnerable Communities. https://www.aha.org/system/files/content/16/ensuring-access-taskforce-report.pdf. Published November 29, 2016. Accessed August 21, 2024.
24. American Academy of Family Physicians. Poverty and health - the family medicine perspective (position paper). https://www.aafp.org/about/policies/all/poverty-health.html. Published 2019. Accessed August 21, 2024.
25. Thompson T, McQueen A, Croston M, et al. Social needs and health-related outcomes among Medicaid beneficiaries. Health Educ Behav 2019;46:436–444.
26. Bonato F, Ferreli C, Satta R, et al. Syphilis and the COVID-19 pandemic: did the lockdown stop risky sexual behavior? Clin Dermatol 2021;39:710–713.
27. Sambyal A, Dogra NK, Ranjan S, et al. Syphilis and COVID-19: changing trends. Indian J Sex Transm Dis AIDS 2023;44:132–134.
28. Kaur T, Mahajan M, Mahajan BB. Syphilis resurgence: exploring the impact of COVID-19 pandemic. Indian J Sex Transm Dis AIDS 2023;44:95–96.
29. SIECUS. State profiles: Texas state profile. Texas’ sex education snapshot. https://siecus.org/stateprofiles/texas-state-profile/. Published 2020. Accessed April 24, 2025.
30. Institute of Medicine Committee for the Study of the Future of Public Health. Public health as a problem-solving activity: barriers to effective action. In: The Future of Public Health. Washington, DC: The National Academies Press; 1988.
