Thanks for sharing the startling statistics on congenital syphilis in the recent issue of AJN (In the News, July). I do believe the article is informative and necessary. However, can you see how highlighting risk factors (poor access, unemployment, homelessness, and substance abuse) and directly following risks with the statement that "the rate of reported cases of congenital syphilis among Hispanic, American Indian/Alaskan Native, and Black populations is three to six times higher than among White populations" is racially misleading and could perpetuate stereotypes? Statements like this could create a false narrative that certain groups are sexually transmitted infection (STI) spreaders when, in fact, you see syphilis and congenital syphilis across all races. Could you consider including that Whites comprise the largest number of syphilis cases1 and contextualizing rates? By doing so, the journal could help destigmatize STIs, reduce the risk of seeing certain groups through the lens of a "negative stereotype" (cultural bias), reveal the impact of structural racism, and decrease attribution errors in health care.

Lastly, reporting rates that intentionally/unintentionally mischaracterize racialized groups must cease. Journals must see their role in shaping and furthering mental models that could dehumanize certain groups. Please share how syphilis impacts all men and women and include numbers that reveal the truth behind rates and avoid contributing to inaccurate conclusions. Thank you for letting me share my thoughts. This is an extremely important topic.

Kenya Beard, EdD, AGACNP-BC, ANEF, FAAN

Dobbs Ferry, NY

REFERENCE

1. Centers for Disease Control and Prevention. Table 16A. Primary and secondary syphilis-reported cases by race/Hispanic ethnicity, age group, and sex, United States, 2021. Atlanta, GA; 2023 Apr 11. Sexually transmitted disease surveillance 2021; https://www.cdc.gov/std/statistics/2021/tables/16a.htm. [Context Link]

AJN news editor Karen Roush responds: At AJN, we're committed to advancing health equity and try to ensure that the influence of structural racism is clear to readers in the articles we publish. We understand how many people, nurses among them, continue to blame disparities on individual or group behaviors and characteristics, and strongly agree that it's critical we get this right. The challenge in short news articles is how to address the underlying structural and individual racism in reported disparities within the confines of space, while also staying focused on the news topic. In this case, we see how the piece could have been written to avoid the problems you point out, including less focus on epidemiology and more context. We can do better, and we will.