Syphilis

sexual health pages

What is it?

Syphilis is an infection caused by a bacterium, Treponema pallidum.

How common is it?

Until recently syphilis was uncommon in the UK, but now the number of new infections is increasing, particularly amongst gay and bisexual men. As a result it is helpful to be aware of this infection and its potential to spread easily from one person to another.

How is it transmitted?

The syphilis bacteria usually enter your body through soft skin- like in your mouth, your arse or on your dick. Syphilis is very easily passed on from one person to another, usually sexually, although this need not always be penetrative sex and can include any combination of oral, genital and anal sexual contact. So the bacteria can be passed on via the mouth during oral sex, and any combination of oral, genital and anal sex. That includes kissing, rimming, fingering, fucking or being fucked, sucking or being sucked. It cannot be caught from towels, crockery or other similar means, as the germ is fragile and cannot live outside the body. A syphilis infection makes it easier to catch HIV if exposed (up to eleven times easier!) and being HIV positive makes it easier to catch syphilis.

I have HIV - What should I be aware of when it comes to syphilis?

Having HIV makes it easier to get syphilis - which can seriously undermine your general health. It even raises your viral load and makes HIV more infectious. If you have HIV it is important to realise that what's safe for HIV is not necessarily safe for syphilis, and so your usual prevention methods (condoms, oral sex without ejaculation etc) won't always stop you getting or passing on syphilis.

What are the symptoms?

Only a minority of people notice any symptoms (about a third). The syptoms are generally painless and can easily go unrecognised. They can also come and go in cycles- making some people think it has gone away completely. Most people become aware of the fact that they’re infected when they have a routine syphilis blood test. The incubation period can range from 9-90 days, so if you think you have been at risk, have a final blood check three months after any possible exposure to the infection. If symptoms do appear during the first stage of infection, they may include a small, painless ulcer which will be raised, red and usually has a hard edge. This might be on your dick, lip or at the edge of your arse, or even on your skin. After a week or two this small but infectious ulcer goes away by itself, so even those people who noticed something wrong can think the infection has gone away. Even though the sore has disappeared, the infection is still in the body and can still infect others. It is possible to get syphilis from someone who appears to be completely free of any symptoms. The second stage of symptoms affects most people about six to ten weeks later. These symptoms can be: fevers, general tiredness, swollen glands, a painless rash (often on the palms of the hand or soles of the feet), sores on the arse and sometimes patchy hair loss. Syphilis is still treatable at this stage, but delaying treatment can be dangerous because the bacteria can be doing you harm without you realising it. Serious complications can occur many years later (up to 40 years), but only if undiagnosed and untreated. This stage of syphilis can cause damage to your heart, brain and nervous system.

What is the treatment?

Syphilis is very easily treated with a course of penicillin - probably best given by injection, although there are alternatives available if you don’t like injections or are allergic to penicillins. It is important to ensure that the infection has been adequately treated; this can only be done by having regular blood tests after treatment. Following successful treatment for syphilis, one of the specific blood tests for syphilis will remain positive; this merely indicates past infection.

What about my partner?

As syphilis is so easily passed on from one person to another, it’s usually best if you discuss the diagnosis with your recent partners. Before you tell your partner, be sure that you yourself are clear about the facts and feel confident. Reassure them that it is quite likely that they may not be noticing any symptoms, but could still be carrying the infection. The health adviser at the GUM Clinic can help you prepare for telling your partner.

For further information on this and a range of other important sexual health issues, contact the GUM Clinic or Gay Men’s Health.

Images courtesy of the Steve Retson Project

Last updated 20th May 2004

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