Colorado confronts rise in syphilis amid drop in federal health funding

DENVER — A dozen doulas and health professionals from around Colorado gathered in a virtual meeting late August to confront the rampant spread of syphilis in the state, which has surged to its highest levels since the 1950s.

Colorado was one of six states with more than a 400% increase in maternal syphilis rates from 2016 to 2022, according to the Centers for Disease Control and Prevention (CDC).

“I didn’t know that much about it before,” said Sarah Lopez, a doula with Elephant Circle, a Colorado-based organization dedicated to improving outcomes and experiences for birthing people. 

“But we can help clients get testing done, reduce stigma, and let them know that we’re not here to judge,” she said.

Lopez, along with Pia Long, director of birth justice infrastructure at Elephant Circle, hosted the gathering — an informational session led by two members of the Colorado Department of Health & Environment — to equip doulas with knowledge about the sexually transmitted bacterial infection.

 

Syphilis, the focus of the session, is an STI that was considered nearly eradicated in the U.S. by the 1990s, but it re-emerged as a public health crisis in the 2000s., The STI, according to the Colorado Department of Public Health & Environment, develops in stages and, if left untreated, can become deadly. With testing or treatment, however, it can be cured. 

Babies can contract syphilis from their mother during pregnancy, a condition called congenital syphilis. It can lead to miscarriage, stillbirth, or early birth. Babies born with syphilis can also have a large liver or spleen and problems with their bones, teeth, or eyes.

Between 2019 and 2024, syphilis cases in Colorado rose by 126%, climbing from 1,524 to 3,451, according to state data. During the same period, babies born with syphilis increased more than fivefold — from 12 in 2019 to 63 in 2024. 

In response to rising congenital syphilis cases, the Colorado Department of Public Health and Environment issued a public health order in April 2024 expanding access to syphilis testing during pregnancy. 

Then, in January 2025, the department adopted regulation requiring health care providers to offer testing at least three times: in the first and third trimesters of pregnancy and at the time of delivery.

During the session, the doulas also learned that pregnant women are able to breastfeed even with a syphilis diagnosis as long as there aren’t any active sores on the breasts or nipples. If there is a rash on the breast, the advice is to 'pump and dump' to maintain milk supply until it’s safe to resume breastfeeding.

“I’ve just actually had two clients that were told they couldn’t breastfeed because of their syphilis,” said Lopez, a doula for 11 years who works with patients in the Denver metropolitan area.

For one of her clients, who had breastfed her older children, opting out affected her recovery, she said.  

“I think, in my opinion, it was part of the reason there was some postpartum depression. It made her feel inadequate,” Lopez said. 

Lopez added that her client should have been able to breastfeed. She didn’t have any rash or cracked nipples or bleeding and she was also on antibiotics.

Even getting a diagnosis for syphilis can be difficult. Trish Martinez Samora of Aurora tested positive for syphilis in 2021, a few months after giving birth to her son, she said. But after a follow-up test, the result came back negative.

“They didn’t test me again to make sure I didn’t have it,” said Samora, whose son does not have syphilis. According to the CDC, using only one type of blood test is not enough to diagnose syphilis. This can cause false-negative results in early syphilis.

Two years later, in 2023, she was flagged for showing up positive for syphilis at a plasma center while trying to donate blood. When she went to the doctor’s, she said, they told her she didn’t have it based on old records and failed to test her again.

In August 2025, Martinez Samora returned to the doctor and tested positive for syphilis.

“The amount in my system was super low. I am not sure exactly when I got syphilis, but I know I have been living with it for the last four years,” she said.

Martinez Samora finished her three shot series of penicillin, the standard treatment for the infection, on the first of week of September. Martinez Samora’s experience reveals that even before the budget cuts, gaps in the system allowed serious infections like syphilis to go undetected. 

“They kind of fumbled the ball with me,” she said of her treatment. “They didn’t immediately test me after I tested positive and then negative. I could’ve had severe nerve damage, brain damage, lost my vision. Thank God none of that happened to me. It sucks that you have somebody like me who slips through those cracks of the system.”

Raising public awareness about syphilis remains a challenge — one that may become even more difficult. In March of 2025, the Colorado state health department lost more than $200 million in federal funding, a portion of which was intended to support infectious disease prevention, including STI programs, according to CPR News. 

“Most of the initial challenges were related to funding for increased testing,” said Hope Shuler, interim communications director for CDPHE. 

She added that the health department has been working with providers and health care facilities through syphilis-focused groups, as well as outreach programs, to help address these challenges. 

With Field-Delivered Therapy, trained health department staff can bring STI medications or prescriptions straight to patient’s doors, reducing the stress of stigma, according to the Colorado state health department. Residents can also order an at home syphilis test kit for free from the department's website. 

“Even with increased awareness and access to testing, STIs are still very stigmatized. We are working hard to normalize STI screening,” Shuler said.