Syphilis has surged in Clark County in recent years, a trend reflected throughout the United States. It’s especially an issue for Clark County’s growing population of homeless people, who lack medical care and are more at risk of sexual assault, experts say.
Cases of syphilis in Clark County have increased by 175 percent since 2018, according to Clark County Public Health. The infection is transmitted through skin-to-skin contact usually during sex, according to the World Health Organization. If untreated, it can be fatal.
People in Clark County’s homeless camps say many are afraid of the sexually transmitted infection. They say they’ve noticed more people exhibiting symptoms of syphilis, specifically sores and rashes.
Columbia River Mental Health offers mobile medical services to screen and treat people living outside for sexually transmitted infections.
Kurt Kenoyer, a physician assistant working for Columbia River Mental Health’s mobile street medicine team, said homeless people are more at risk for these infections for a number of reasons.
People under the influence of substances or with mental health issues (problems more common in the homeless population than the general public) can exhibit poor judgment when sexually active, Kenoyer said. Homeless people, especially women and youth, are more likely to experience sexual assault than the general population, according to the National Sexual Violence Resource Center.
“Those factors certainly need to be included into the risk profile for this population,” Kenoyer said.
He said syphilis has been the most prevalent sexually transmitted infection in homeless camps.
“My experience so far is that it often comes in waves,” Kenoyer said. “So there will be periods of time where we will not have that issue come up with our clients or they don’t request testing for it. And then other times, it’ll seem like it’s the issue of the week.”
The most memorable wave for Kenoyer occurred in 2022 when a camp in Vancouver’s North Image neighborhood called The Swamps existed.
“I wouldn’t call it an outbreak, but there were quite a few clients there that we were trying to treat and also get tested,” he said.
That encampment was removed after a fire destroyed much of the camp the following year. Kenoyer said a major difficulty in testing and treating homeless people is that they often migrate elsewhere.
“The difficulty comes in once they’re tested, and we have the result. … Their camp can move frequently, or they’re forced to move,” he said.
People also struggle to keep their medication from being stolen or destroyed by weather in camps, he said.
Columbia River Mental Health staff often bring testing equipment and condoms to events that homeless people might attend. Clark County Public Health has free self-test kits for sexually transmitted infections.
Still, not enough people are being tested, Kenoyer said. He hopes Columbia River Mental Health will have a mobile clinic one day where people can discuss their concerns in a private setting rather than the public space where they live.
People in these camps sometimes refuse help from medical professionals because of a bad experience with health care in the past, Kenoyer said.
“Part of my job is trying to repair the relationship between medicine and these clients so that they can develop that trust again and reach out for help beyond Columbia River,” he said.
