3rd Edition of the Public Health and Midwifery World Conference 2027

Abstract

This educational session will equip providers to confidently recognize and manage the clinical complexities of syphilis, famously known as "The Great Imitator." Because this infection mimics other conditions, it routinely leads to misdiagnoses, delayed care, or improper treatment. This diagnostic gap is particularly dangerous now, as infection rates are exploding across the United States. Left unchecked, delayed treatment allows the disease to transition quietly into late-stage latency. This progression is causing an alarming surge in cases of tertiary syphilis. Providers must intervene early to stop the progression toward devastating, permanent body damage. Compounding this public health crisis is a dramatic rise in congenital syphilis. This trend highlights the critical need for timely prenatal screening. Fortunately, treating the pregnant individual effectively cures the infection and prevents transmission to the baby.

To address these challenges, this presentation provides a clear testing framework to untangle confusing laboratory pathways. Attendees will learn how to master IgG, IgM, CIA, RPR endpoint titers, and TPPA assays. Using a simple chart and interactive, real-world case studies, providers will gain a better understanding of how to track syphilis results for future reference and treatment. Participants will build critical advanced practice skills to resolve conflicting lab results, successfully preventing misclassification, delayed treatment, or overtreatment.

This session also highlights the critical safety-net collaboration between the Cleveland Department of Public Health and MetroHealth Medical Center. Local data reveals unique operational challenges. The joint project must manage a steep surge in community syphilis while experiencing a very low volume of pregnant patients—averaging only one or two pregnant individuals per year at the city clinic. This presentation demonstrates how the city and hospital systems partner to ensure these rare, high-stakes prenatal cases do not fall through the cracks. Attendees will see how a joint project between a large urban hospital and a department of health can ensure rapid treatment of syphilis and a seamless transition into maternal HIV prevention. Furthermore, this joint partnership creates a vital opportunity to treat syphilis and initiate HIV prevention early during preconception counseling.

Data also reveals a profound syndemic relationship between syphilis and HIV. A syphilis diagnosis doubles a patient's risk of acquiring HIV due to shared social networks, structural factors, and biological vulnerabilities. This risk is equally critical during pregnancy; a pregnant individual diagnosed with syphilis is at a significantly higher risk for HIV. Fortunately, there are several safe forms of PrEP and PEP available during pregnancy. This session will review these options, increasing your knowledge of maternal HIV prevention. Finally, attendees will learn how to counsel eligible populations on utilizing PrEP and PEP after a syphilis diagnosis to reduce HIV incidence. By linking reactive laboratory results to active HIV prevention, attendees will leave equipped to treat syphilis, break the syndemic cycle, prevent late-stage disease, and eliminate neonatal infections.

Learning Objectives

By the end of this session, participants will be able to:

1. Interpret complex syphilis serologies and confusing laboratory pathways—including IgG, IgM, CIA, RPR endpoint titers, and TPPA assays—to resolve conflicting results and prevent misclassification or improper treatment.
2. Describe the operational strategies of a public-private safety-net partnership (such as the joint project between the Cleveland Department of Public Health and MetroHealth Medical Center) to effectively manage community surges and coordinate rapid care for low-volume, high-stakes prenatal and preconception cases.
3. Evaluate clinical opportunities to break the syphilis-HIV syndemic cycle by safely implementing and counseling eligible populations on HIV pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) during pregnancy or preconception care