Syphilis cases rise among San Diego drug-using homeless as NIH rules and penicillin shortage hinder care

A UC San Diego study of unhoused drug users on both sides of the San Ysidro border revealed that roughly one in ten participants tested positive for active syphilis, a condition that often remains unnoticed without targeted screening. The project’s outreach worker, Carlos Vera, has long relied on personal relationships to reach people living in tents and encampments, delivering diagnoses and linking them to free clinic care.

Recent NIH policy changes barred any foreign subawards, compelling the team to abandon its Tijuana field office and lay off staff, thereby limiting cross-border data collection. Simultaneously, a shortage of the recommended intramuscular penicillin forced the county clinic to prescribe a 30-day course of oral doxycycline, a regimen difficult for transient populations to adhere to. Epidemiologists Steffanie Strathdee and Britt Skaathun stress that the combined effect of reduced surveillance and suboptimal treatment could allow the outbreak to spread unchecked.

The situation underscores how federal funding rules and supply-chain issues can directly impact public-health interventions for vulnerable groups. Researchers hope future grant reforms and a resolution of the penicillin shortage will restore comprehensive care.