Syphilis
  • Syphilis is an STI that can be passed on through vaginal, anal and oral sex
  • A quick physical examination and blood test will show if you have syphilis or not
  • Early symptoms of syphilis can be easily treated with a course of antibiotics
  • Left untreated syphilis can develop into a more serious health condition
Syphilis

    Syphilis is Back

    Think you don’t have to worry about syphilis anymore? Think again. Since 2000, syphilis rates have surged worldwide. Syphilis is back in Auckland reaching epidemic levels in 2014 and has continued to rise. In 2015 and 2016, Auckland saw the highest rates of syphilis in over 30 years.

    Most of our syphilis infections are in gay, bisexual and other men who have sex with men (cis and trans). The highest infection rates are among younger men (20-39 years). And about half of all infections are in gay men who are also living with HIV. Syphilis and HIV do not play well together – not only can syphilis increase your chances of getting or passing HIV, but HIV can also increase the risk of complications due to syphilis.

    The challenge with syphilis is that 50% of people with syphilis do not have symptoms and aren’t aware they have it. Actually, 1 in 5 sexually active people have some form of sexually transmitted infection.
    Transmission 
    Syphilis is very infectious. If you have syphilis in its earlier stages, the chance of passing it to a partner is very high.

    Syphilis is passed through direct contact with a syphilis lesion (such as a sore or area of inflamed tissue which may be small and unrecognised) during oral or penetrative sex. People who are pregnant and get syphilis can also pass it to their baby.

    While wearing a condom is always recommended, sometime syphilis lesions occur on areas that aren't covered by a condom. So it's still possible to get syphilis even if you are using a condom. It can be passed through breaks in the skin or from touching a lesion on a person who has syphilis.

    If you get syphilis once, it does not protect you against getting syphilis again. People can get syphilis multiple times in their life, even if they are treated with medication each time as it is not a vaccine.
    Symptoms 
    Syphilis goes through several different stages. While the stages have different symptoms, syphilis may not cause noticeable symptoms or even any symptoms at all.

    Primary Syphilis: The main symptom is a painless sore, called a 'chancre'. It will appear on your cock, balls, mouth, throat or arse, turn into a scab and then heal. It usually takes 3 weeks after infection for the sore to develop, but it can take up to 3 months. You may not even notice it. This stage is very infectious. If left untreated the sore will disappear after a few weeks, but the infection will progress.

    Secondary Syphilis: Symptoms can include a rash on the body (often on the palms and soles of feet), patchy hair loss, fever, enlarged lymph nodes ("swollen glands") or a general feeling of being unwell. These symptoms usually show up 2 to 12 weeks after infection, but can take up to 6 months. You may not notice these symptoms either. There is also the chance at this stage for syphilis to infect major organs (e.g. liver, brain, kidneys). This stage is very infectious.

    Latent Syphilis: This is a hidden stage, where the person is infected with syphilis but doesn't have any symptoms. Syphilis can still be passed on to other people during this stage.

    Tertiary Syphilis: This is the stage in which syphilis has infected major organs, like the heart or brain. It can cause permanent damage and very serious complications. For example, in the heart, syphilis can damage the aorta and heart valves. In the brain (known as neurosyphilis), it can cause many symptoms, from headaches and dizziness to dementia and changes in personality. It can also infect the nerves, causing blindness, deafness, paralysis or even death.

    While tertiary syphilis usually takes years to develop, syphilis can sometimes affect major organs early on. Neurosyphilis can occur at any stage of syphilis infection. People living with HIV who have been infected with syphilis are at higher risk of developing neurosyphilis than those who are HIV-negative.

    Get Tested

    The only way to know if you have syphilis is to get tested.

    Syphilis testing is usually done with a blood test. However, it may take up to 3 months before syphilis can be detected by the blood test. So, if you think you have been exposed to syphilis in the last 3 months, you need to get tested and treated. If you have been notified by a sexual partner that you may have been exposed visit a clinic as soon as possible so that you don't pass it on.

    The recommendation for Gay and Bi guys is to test at least once a year - every 3 months if you have multiple sex partners or casual partners.

    Get Treated

    The good news is, syphilis is easily treated. The best treatment for syphilis is a penicillin injection. Depending on the stage of infection, it can take up to 3 injections of penicillin to cure syphilis. Intravenous penicillin for 10 to 14 days is needed to cure neurosyphilis - so catch it early.

    If you are allergic to penicillin, another antibiotic (doxycycline) can be used to treat syphilis.

    Once you are treated this doesn't stop you from getting syphilis again. People can get syphilis multiple times in their life. Its important that we are proactive as a community to stop the spread of syphilis and curb the epidemic.

    Protect Others

    Using condoms can help prevent syphilis, but it's still possible to pass it on even with a condom if the sore or lesion is outside the area the condom covers.

    Another good way to protect your partner is to regularly test for syphilis. We recommend annual testing and sexually active gay or bisexual men (both cis and trans) should get tested every 3 months. Because syphilis may not have symptoms, getting tested is the only way to know if you have it.

    If you get syphilis, it is important to let your sex partners know so they can be tested and treated for syphilis too. Because it is so contagious, syphilis can spread very quickly within the community. Making sure your partners get tested and treated as soon as possible will help stop syphilis from spreading.

    The period of time when partners are at risk for syphilis depends on the stage of syphilis. This is known as the "trace-back" period. The trace-back period is 3 months for primary syphilis, 6 months for secondary syphilis, and 12 months for early latent syphilis. Anyone you had sex with during the trace-back period is at risk of getting syphilis and should be tested. Anyone you had sex with in the last 3 months should also get treated, because it can take up to 3 months for a blood test to become positive.
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