Addressing the Increase of Syphilis in Arizona

Based on the recommendation from the Arizona Department of Health Services (ADHS), with support from the Center for Disease Control (CDC), the Arizona Health Care Cost Containment System (AHCCCS) is covering three syphilis screenings during pregnancy statewide effective immediately.

That means that for the duration of the Arizona syphilis outbreak, AHCCCS will cover all of the augmented screening recommendations statewide:

  1. All pregnant women at first prenatal visit, early in the third trimester, and at delivery, regardless of risk.
  2. Opt-out screening in both men and women who use drugs.
  3. Sexually active men who have sex with men: testing annually and every 3-6 months if at increased risk.
  4. Sexually active persons with HIV: testing at least annually and every 3-6 months if at increased risk.
Chart of Congenital Syphilis Rates Have Risen Sharply
Source: https://kffhealthnews.org/news/article/babies-die-as-congenital-syphilis-continues-a-decade-long-surge-across-the-us/

As of 2021, Arizona has the highest rate of congenital syphilis in the United States. In a CDC report from Nov. 2023, 38% of pregnancies resulting in congenital syphilis had no prenatal care. Many people who are not in prenatal care are visiting emergency departments and urgent care centers during their pregnancy. This presents an opportunity to prevent infection.

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid program, covers all medically necessary services for pregnant AHCCCS members, including screening and treatment of syphilis in urgent care and emergency department settings.

In order to address this trend, the Policy Guidance issued by the Arizona Department of Health Services (ADHS) and AHCCCS is:

  1. Rapid screen and treat pregnant persons for syphilis who present in an Emergency Department or Urgent Care, regardless of their chief complaint. AHCCCS and ADHS recommend that hospitals implement a rapid screening and treatment program for pregnant persons in the ED/Urgent Care settings.
  2. Rapid screen and treat persons with suspect illicit substance use who present in an Emergency Department or Urgent Care, regardless of their chief complaint.
  3. Include a syphilis cascade anytime a blood draw is taken (red top tube).
  4. Call for titer histories:

Please visit the ADHS Arizona Syphilis Outbreak webpage for all screening, treatment, or reporting updates related to the outbreak.

To learn more visit:

For additional resources on syphilis prevention, screening and treatment, please refer to:

The CDC STI Treatment Guidelines or the ADHS Arizona Syphilis Outbreak webpage for updated information on the outbreak.

Resources: