Infectious syphilis in women and heterosexual men in major Australian cities: sentinel surveillance data, 2011–2019

To the Editor: Carter and colleagues recently reported on infectious syphilis among women and heterosexual men attending sexual health services in major Australian cities.1 Of note, the authors found that among women, recent injection drug use was associated with an increased risk of syphilis. This follows data from Canada and the United States where substance use, including injection drug use, has been reported among many people diagnosed with syphilis in recent years.2,3 All these authors have suggested syphilis testing needs to be offered to people attending alcohol and other drug services. Given how difficult it is to achieve a reduction in sexually transmissible infections (STIs) once they are widespread in population groups, we wholeheartedly support this notion, and implore that this be given greater attention in state and national STI strategic plans and associated funding allocations.