What is it and how do I get it?

Syphilis is a bacterial infection which is most usually transmitted through sex without a condom and oral, but which can also be caught through rimming, fisting and even through skin to skin contact (although this is rare). Throughout the 1990s syphilis was relatively rare, but the number of people (esp gay and bisexual men) seeking treatment for syphilis in the last few years has increased considerably.

Higher rates of syphilis are seen in HIV-positive people than HIV-negative people (once again, particularly gay and bisexual men). They are more likely to experience early symptomatic neurosyphilis, a rare but serious manifestation of syphilis in the brain that usually occurs within the first twelve months of infection. For this reason, it is recommended that all people diagnosed with HIV are regularly tested for syphilis.

How do I prevent it?

Using condoms will prevent many cases of syphilis. If you wanted to reduce the risks further, you would have to use condoms for oral sex. 

How do I know I've got it?

The symptoms develop in four stages:

Stage 1 (also known as primary syphilis):

A small painless sore or hardened lump will appear one to ten weeks after infection, near the point where the bacteria entered your body. This could be your bum, penis, vagina, or mouth. It's possible for this to go unnoticed, especially if it is in your bum.

Stage 2 (aka secondary syphilis):

Up to two to six months later, you may experience a rash on the body and a flu-like illness involving fever, headache and sore throat. The symptoms between stage one and stage two may be mild and difficult to spot.

Stage 3 (aka early latent syphilis):

At this stage syphilis usually has no symptoms but as the infection at this stage is established in the blood it can be easily transmitted to sexual partners.

Stage 4 (aka late latent syphilis):

Here's the bad bit – after a couple of years, if left untreated, syphilis will stop being contagious to sexual partners but at this stage the infection can cause blindness, deafness, brain damage, heart attacks, paralysis, lung problems and strokes.

A sexual health clinic can test you for syphilis and this should form part of routine sexual health check-ups. It is usually tested for by taking a blood sample, although other bodily fluids are sometimes taken in the late stages of syphilis. Any sores you have may also be examined for signs of syphilis.

How do I get it treated?

Syphilis, if treated early enough, is completely curable with antibiotics, causing no permanent damage. Even at the latest stage syphilis is still curable, but any damage done by the syphilis may be irreparable. Because the symptoms are easy to miss, it's worth having regular sexual health check-ups, including blood tests for syphilis, if you are sexually active and especially if you have unprotected sex with new partners. Blood testing for syphilis typically involves three testing processes and after an infection, even if it is cured, some of these tests will give a positive result. It is important to follow the advice from the GUM clinic as it may be difficult to tell whether the test is reacting to the previous infection or to a new infection of syphilis.

Which sexual partners should I inform if I've been diagnosed with syphilis?

If you have primary syphilis, you should inform anyone you had sex with up to three months before symptoms started, plus anyone you slept with after symptoms appeared. If you have secondary syphilis or early latent syphilis, you should inform anyone you've had sex with in the last two years. Often, this is not practical and you may only be able to notify some of your partners. As syphilis can easily go undetected you should make efforts to inform as many partners as possible.

Last updated: 19/11/2016