Survey reveals many Americans don't know much about STIs like syphilis

Sexually Transmitted Infections
Couple on beach

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Many US adults harbor misconceptions about sexually transmitted infections (STIs) such as syphilis, despite its potential seriousness and cases rising around the world, the latest University of Pennsylvania Annenberg Public Policy Center (APPC) survey shows.

APPC fielded the Annenberg Science and Public Health Knowledge survey to a national probability sample of more than 1,500 US adults from April 18 to 24. Respondents were asked about their knowledge of STIs, with particular attention to syphilis and HIV.

The authors noted that the Centers for Disease Control and Prevention (CDC) reported in January that syphilis cases rose 80% from 2018 to 2022, with more than 200,000 infections in 2022, the most recent year with available data.

Unfamiliarity with syphilis symptoms

Just over half of respondents (54%) knew that syphilis can be cured, most (84%) mistakenly believed that a vaccine to prevent the disease is available, and 45% said they weren't sure whether there is a vaccine.

Many didn't know the signs and symptoms of syphilis, including sores (30%), swollen lymph nodes (28%), fever (27%), weight loss (16%), dizziness or lightheadedness (13%), and blurry vision (12%). But high proportions were familiar with ways to protect themselves against it, including abstinence (78%) and using a condom (77%).

With the rising number of syphilis cases, knowing the causes, symptoms, and treatment for it assumes added importance.

Kathleen Hall Jamieson, PhD

A total of 94% knew that oral contraception, diaphragm use, and getting vaccinated (there is no vaccine) weren't effective against infection, but 71% didn't correctly cite using clean needles as a protective measure.

"With the rising number of syphilis cases, knowing the causes, symptoms, and treatment for it assumes added importance," APPC Director Kathleen Hall Jamieson, PhD, said in the news release.

Only one third of respondents correctly said that human papillomavirus (HPV) can't be cured, and another third didn't know a vaccine is available to prevent infection and related cancers. But most knew that HIV can spread through unprotected sex (95%), sharing needles (90%), and childbirth (67%) and that the virus can't spread through airborne droplets (89%), touching contaminated surfaces (88%), or using recreational drugs called poppers (85%). 

Only 33% knew that HIV can also spread via breastfeeding. In total, 42% of respondents correctly indicated that most US HIV patients don't develop AIDS, and 38% knew it's easier to get HIV if a person already has another STI.

Confusion over vaccine availability

Considerably less than half (39%) knew that mpox is usually sexually transmitted, and 12% incorrectly identified mosquito-borne Zika as an STI. A total of 98% of respondents knew STIs spread through vaginal sex, and most also indicated they can be transmitted through oral sex (89%), anal sex (93%), and genital contact (91%).

Over half of respondents knew that gonorrhea (65%), chlamydia (63%), and syphilis (54%) can be cured, but only 29% knew that mpox has a cure. Others thought that incurable diseases can be cured, including Zika (91%), HPV (65%), genital herpes (42%), and HIV (26%).

Most adults (67%) knew that a vaccine is available for HPV, but only 44% knew there is an mpox vaccine. Large proportions didn't know that there's no vaccine for Zika (80%), syphilis (61%), HIV (52%), gonorrhea (57%), genital herpes (55%), and chlamydia (59%).

High proportions knew that someone with an STI can spread it to others even if asymptomatic (91%), that drugs can control HIV and prevent disease advancement (87%), that an STI can pass from a pregnant woman to her baby (78%), and that HPV can cause cancer in women (69%).

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