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Syphilis

Overview

Let’s beat syphilis.
Syphilis is spreading fast among gay and bisexual men. You can help stop its spread by learning more about the disease and getting tested. This site provides the information you need.
Make syphilis testing part of your routine.
If you are sexually active, make (sexually transmitted infection) STI testing part of your routine. You have a few options:
  • Visit a testing site for free or low-cost testing
  • Get tested at your own health care provider's office or health center
Syphilis is curable.
Syphilis is treated with antibiotics and can be cured – but it’s important to be tested early. Untreated, syphilis can cause blindness, heart problems, and brain damage. Routine testing can help you and your partners stay safe.
Syphilis is a sexually transmitted infection caused by a bacterium (called Treponema pallidium). The bacterium can cause painless sores or ulcers. Syphilis is spread through contact with these infected sores during oral, anal, or vaginal sex.

Sores or ulcers are called “chancres” (pronounced shan-ker) and for men are usually found on or around the penis, anus, or mouth. This is the first stage of syphilis, called primary syphilis. Even untreated, symptoms will disappear – but the infection has not gone away. This can lead to the next stage, called secondary syphilis. Secondary syphilis can cause a rash, multiple sores, hair loss, white patches on the tongue, or wart-like growths. Late syphilis, or tertiary syphilis, is very dangerous and can cause blindness, mental illness, heart problems, and even lead to death. Learn more about symptoms.

You may have heard that syphilis was a problem centuries ago. That’s true, but now syphilis rates are growing among gay and bisexual men, especially in cities like Boston. The number of syphilis infections among men who have sex with men has risen dramatically in the last 3 years.

Another important reason to protect yourself and get tested is that syphilis infection makes it much more likely to get or give HIV infection.
Factors known to increase the risk of contracting the infection include:
  • Unprotected sex, especially with someone who has multiple partners or is known to have herpes
  • People with HIV infection are more likely to contract herpes simplex infection because of their decreased ability to fight infection
Within 90 days of being infected – an average of 3 weeks – a painless sore or ulcer appears (called a chancre). For men, the chancre is usually found on or around the penis, anus, or mouth. This first stage is called primary syphilis. The chancre contains a clear fluid that is full of bacteria, making you very contagious. Even without treatment, the chancre will heal in a few weeks. Get tested and seek treatment if you have these symptoms.

Syphilis symptoms can be easy to miss and are different from person to person. You can have syphilis even without noticeable symptoms. This is why testing is important (every 6 months), especially if you’ve had sex with someone who has syphilis.

If left untreated, syphilis will progress. After the chancre heals, there may be a period of time without any symptoms, called a latent period. Then other symptoms will appear, called secondary syphilis. Symptoms of secondary syphilis can include:
  • Muscle pain, headache, and fever
  • A rash on the body
  • Spots on the palms of the hands and soles of the feet
  • Hair loss
  • White patches on the tongue
  • Wart-like growths (called condylomata lata)
It may take up to several weeks for these symptoms to appear, so many people don’t realize it’s related to sex they may have had long ago. These symptoms will go away without treatment, but you can still infect others. Get tested and seek treatment if you have these symptoms.

If untreated, people with syphilis may develop late syphilis, also called tertiary syphilis. This takes many years but is very harmful and can even lead to death. Late syphilis can cause blindness, mental illness, heart and brain problems, and other organ damage. An infection of the brain can occur at any stage of syphilis.
Testing is easy and safe. If you are sexually active, getting tested regularly (every 6 months) will help you find syphilis early and get treated before it spreads to other parts of the body. With treatment, syphilis is curable. By getting tested, you are also helping to protect your partners and the community.
There are a couple of testing options:
  • Visit a testing site if you suspect infection
  • Get checked at your own health care provider's office or health center
The syphilis test is usually a blood test, and takes only a few minutes. If you have a chancre, sometimes a small sample from it can be tested. If you go to your doctor with symptoms, he or she may also recognize the symptoms as syphilis.

Even if you test negative, if you know you’ve had sex with someone who has syphilis, you should get treatment. Sometimes it can take up to 3 months after infection for a person to have a blood test positive for syphilis.
Syphilis is curable. Standard treatment is penicillin shots, and people allergic to penicillin are given different medications. For some people, penicillin doesn’t work, so it’s important to get tested regularly to make sure the syphilis has been cured.

Even if you are treated for syphilis, you can become infected again. Treatment does not make you immune to syphilis.

If you are HIV-positive or your immune system is compromised for another reason, you will need more medication and should see your doctor regularly.
If you’re sexually active, make syphilis testing part of your routine (every 6 months). If you have any symptoms, get tested and seek treatment – it will help you stay healthy and not infect partners.

Condoms and dental dams can help prevent syphilis, but they aren’t 100% effective. If you notice a partner has sores or ulcers, the safest thing is to not have sex – and remember, oral, anal, and vaginal sex can spread syphilis. Reducing your number of partners can also help you lower your risk of syphilis infection.

To help protect your partners and the community:
  • Don’t have sex if you have symptoms or know you’ve been exposed to syphilis
  • Make testing part of your routine
  • Get treatment if you have symptoms or have been exposed to syphilis
All your current sexual partners need to be tested and treated if exposed – it’s easy to be reinfected.
It’s important for everyone to know that syphilis makes it much more likely to acquire or transmit HIV infection.

For people living with HIV infection, syphilis can progress quickly and be more harmful. If you’re HIV-positive and know you’ve been exposed to syphilis, you should get tested and get treatment (whether or not you test positive). If you do test positive for syphilis and get treatment, you should visit your doctor regularly. You may need more medication to cure syphilis.
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Information provided by GetTestedBoston.org
Photos on this page: Freedom, Katie Curl