Syphilis Screening in Correctional Facilities - Alaska, October 2023-September 2025.

Abstract

Since 2017, syphilis cases have increased substantially across the United States, including in Alaska. Nationwide, prevalence of syphilis tends to be higher among incarcerated persons than among the general population. During 2023-2025, opt-out screening for syphilis in Alaska correctional facilities (i.e., routine testing unless a person specifically declines) found reactive rapid plasma reagin (RPR) results, which often indicate a past or current syphilis infection, in 240 (4.6%) of 5,163 persons screened. Among persons with reactive RPR results, 114 (47.5%) had newly identified syphilis cases (2.2% of all persons screened), based on the 2018 Council of State and Territorial Epidemiologists definition. Among persons with newly identified syphilis, 88 (77.2%) were known to have completed treatment by September 2025. Among 1,020 women incarcerated in Alaska who were screened (19.6% of all persons screened), 95 (9.3%) had reactive RPR results. Among those 95 persons, 37 (3.6% of women screened) had newly identified confirmed or probable syphilis, and the remaining 58 (5.7% of women screened) had positive treponemal test results, demonstrating a high current or past syphilis prevalence among women incarcerated in Alaska. Implementing opt-out screening and treatment in correctional facilities could improve syphilis detection and treatment among persons in correctional facilities, and thereby reduce community syphilis transmission and help prevent congenital syphilis.