Near the corner of Russell and Hamburg Streets in downtown Baltimore, in the shadow of the city’s professional football stadium, a new sign just went up inside the bus shelter.
“Don’t Guess,” it reads. “Test.”
The image features a couple, the man happily touching his partner’s pregnant belly.
It’s part of a timely new campaign developed by the Johns Hopkins Center for Communication Programs in collaboration with the Baltimore City Health Department to raise awareness of the harms of syphilis and to prevent its spread in Baltimore. It is aimed at the city’s moms-to-be and their partners, educating them about the serious health consequences of passing syphilis on to an unborn child (congenital syphilis) and sharing information on testing and treatment of what is a preventable sexually transmitted infection.
“We just want to ask the question, do you know if you have syphilis,” says CCP’s Apral Smith, who worked on the messaging. “And that’s meant to be a conversation starter with yourself, with your partner, and to hopefully try and remove the stigma around the conversation about it.”
Because the best way to avoid transmitting syphilis to a baby is for both partners to be tested early and often in prenatal care appointments with obstetric providers or other testing locations. Knowing if you (or your partner) have syphilis is the first step in containing its spread.
“Every family wants their baby to be born healthy, and the communities want babies to be born healthy and thrive,” says August Summers, who leads CCP’s domestic initiatives. “The same way we want people to go to prenatal appointments for every other health aspect, this is also one of the things that should be happening at their first prenatal appointment and again later in the pregnancy: Be tested for syphilis. Everyone who’s pregnant should be tested for syphilis.”
The campaign’s call to action is meant to spark discussion around an infection that community members and health providers told CCP most people know little about despite rising rates in recent years.
In the United States, cases of congenital syphilis spiked by 80 percent between 2018 and 2022, when cases of congenital syphilis among newborns were 10 times higher than they were in 2012. Black and American Indian populations bear a disproportionate share of the burden – and women are making up a growing share of cases.
According to a new web page created through this project, syphilis is a common STI that can be cured with antibiotics. If you do not get treated for syphilis, you can develop serious health problems such as blindness, paralysis, and heart problems.
Congenital cases can cause miscarriage, lifelong medical issues, and infant death.
A 2024 Maryland law, the Giving Infants a Future Without Transmission (GIFT) Act, strengthened reporting and testing standards for HIV and syphilis, requiring every baby born in the state be tested for syphilis at delivery and every mother during the third trimester of pregnancy.
This campaign, created under the B’more for Healthy Babies project, is not just directed at pregnant women, however. If her partner has or contracts syphilis, he could reinfect her if he has the infection, even if she has been treated. The messages, which are also part of a social media campaign, also remind people that while syphilis is treatable, the full course of treatment (which can be up to three shots) is required to ensure the infection has cleared up and the baby is safe.
“We don’t want anybody guessing,” Summers says. “We want people to test for syphilis.”
