Think you may have been exposed to syphilis? Here’s what you need to know.

What is syphilis?

Syphilis is a sexually transmitted infection (STI) caused by bacteria. The symptoms of syphilis can be similar to other diseases, which makes it difficult to diagnose.

How is syphilis spread?

Syphilis is spread a number of ways, including contact with a sore or rash of an infected person, or by way of the mucous membranes, like your mouth and anus. Close physical contact—oral sex, anal sex, rimming and fisting—with a guy who has syphilis will put you at risk for infection. Vancouver is currently experiencing an outbreak of syphilis, concentrated in gay, bi, and other men who have sex with men.

How do I know if I have syphilis?

Symptoms of syphilis come and go in four stages. You might notice them or you might think you have a different health issue.

Primary stage:

  • This stage usually starts within days or weeks after you’ve been infected. At this point, you may notice a painless open sore on the body part that has been in contact with the infection; probably on the penis, testicles, anus or mouth.
  • The infection is passed to other guys through direct contact with the sore. The sore will heal after a few weeks, but even though it goes away, you still have syphilis.
  • Some guys do not notice any sores.

 Secondary stage:

  • About four to ten weeks after infection, you might develop a rash on your chest, on the palms of your hands or on the soles of your feet. General aches and pains or fever may also occur. The infection is passed to other guys through direct genital contact with the rash or mucous membranes (inside of mouth and anus).

Latent stage:

  • Often referred to as the hidden stage, the latent stage of syphilis occurs about a year after infection. While no symptoms may be present, you still have syphilis and you can still easily pass it on to other guys.

 Latent (tertiary) stage:

  • Left untreated, the bacteria can cause serious health concerns including blindness, mental illness, problems with the heart and nervous system and even death.

How do I test for syphilis?

Be honest with a health care professional about your sexual history and symptoms; ask for a physical exam. If you have a sore, fluid may be collected from it. Whether or not you have a sore, a blood test will confirm the diagnosis.

What do I do if I have syphilis?

  • You can’t be cured if you don’t get treatment.
  • Penicillin injections are the treatment of choice. If you are allergic to penicillin, your doctor has other options.
  • Have follow-up blood tests to make sure that the antibiotics worked.
  • Having syphilis once will not make you immune to another infection. You will be reinfected if you are exposed again.
  • Talk to the guys you’ve had sex with so they can be examined, tested and treated.

 How do I protect myself?

  • Regular use of condoms will reduce your chances of getting syphilis and other STIs.
  • PrEP, while effective at preventing HIV transmission, does not protect against other STIs such as syphilis.
  • Syphilis is often passed along by guys who don’t have symptoms and who don’t know they are infected.
  • If you think you’ve been exposed to syphilis, get tested. If you have numerous partners, get tested regularly.
  • Limiting the number of different guys you have sex with will also reduce your risk.
  • Don’t have sex with a guy if he has symptoms or if he is being treated for syphilis.

Syphilis and HIV

  • Having any STI or having sex with someone who has an STI will increase your risk of picking up HIV.
  • If you already have HIV, having syphilis may increase your viral load, increasing the chances that you’ll pass HIV on to others.
  • HIV-positive guys are prone to picking up or passing on syphilis during condomless anal sex with other HIV-positive guys.
  • Regular use of condoms will reduce the risk of picking up or passing on both syphilis and HIV.