Syphilis and CS disproportionately affect women of childbearing age, particularly those in underserved communities. American Indian/Alaska Native, African American, and Hispanic populations experience the highest rates of CS, compared to their White counterparts. Despite existing prevention efforts, those at highest risk remain unreached due to individual, community level, and systemic barriers. These include limited healthcare access, cultural and language barriers, stigma, discrimination, and gaps in education and awareness among both healthcare providers and communities. The most common missed opportunity for syphilis prevention is lack of timely testing and treatment. This evidence-based project explores harm reduction as an alternative approach to syphilis presentation and treatment for high-risk populations. Rather than requiring abstinence, harm reduction aimed to minimize the negative consequences of risky behaviors by meeting people where they are, building trust, supporting gradual behavior change, and increasing access to education and resources. In partnership with local public health centers and community organizations, this harm reduction pilot program will develop targeted strategies such as safe sex kits, educational materials, syringe service programs, and community-based outreach in accessible locations. By tailoring interventions to the unique needs of each community, this project seeks to advance an equity driven model that shifts public health practices toward a more inclusive, patient centered care, and ultimately reduce the rates of STIs, thus improving overall population and community health
