Syphilis has been increasing among gay men.

Although syphilis is very easy to catch, it is more common among men with a high number of sexual partners (more than 10 in the last six months), men who are into group sex, sharing sex toys or fisting, and men who are HIV positive. If you fit any of these categories, you should get tested for syphilis every three to six months.

Please see below for more information about syphilis.

What is it?

Syphilis is an infection in your blood caused by a bacterium called Treponema pallidum.

How do you get it?

Giving or receiving anal or oral sex can transmit syphilis. It can also be passed on through arse play or direct contact with sores or lesions.

What are the symptoms or signs?

It is common for the symptoms of syphilis to go unnoticed however when they do appear they usually occur in 3 stages.

Stage 1:

A red sore (chancre)-which is usually but not always painless-will appear on your penis, testicles, mouth, throat or anus that turns into a scab and then heals. It usually appears at the site of infection. This stage may show up 10-90 days after infection and may go unnoticed. If left untreated the sore will disappear after a few weeks, but the infection will progress to stage 2.

Stage 2:

A rash will appear on the palms of your hands, soles of your feet or other parts of your body. In addition to rashes, second stage symptoms can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle and joint aches, and tiredness. These symptoms can occur 2-6 months the after initial infection and last for 6 months or longer. Without treatment syphilis will progress to stage 3.

Stage 3:

If untreated, syphilis remains in your body and begins to damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. In about one in 10 of untreated people, this internal damage shows up many years later in the late or tertiary stage of syphilis. This damage may be serious enough to cause death.

Although a person may show no visible signs of infection they are still able to pass on syphilis.


Diagnosis is through a blood test but swabs may also be taken if there are sores. If you’re HIV positive, it is recommended to get tested for syphilis every 3 months when getting your regular blood tests to monitor your HIV.

Can it be treated?

Syphilis can be treated with a course of antibiotics. Syphilis can be cured particularly if it is diagnosed in the early stages and treated with penicillin. Other drugs may be used if a person is allergic to penicillin.

How can it be prevented?

Only areas covered by condoms, dams or gloves are protected from infection. Touching any sore or rash should be avoided.

Syphilis & HIV

Syphilis is more common in HIV-positive gay men. There can be significant differences in how syphilis disease progresses in people with HIV. There can be a rapid progression from early syphilis to nervous system involvement in a matter of months, rather than the years or decades it takes in HIV-negative people. The complications to the nervous system may also occur in the early stage of infection, not just in the later stages.

Co-infection with HIV and syphilis may also result in the more rapid onset of HIV disease and AIDS. It can decrease the CD4 count (therefore causing damage to the immune system) as well as increase the viral load of HIV-positive people. This is especially of concern for people with a low CD4 count.

There have also been cases of treatment failure in patients with secondary syphilis, all of whom were HIV-positive. People with HIV can also progress to neurosyphilis despite standard treatment. If you have syphilis (early or latent) careful monitoring is advised, so that any abnormality is treated immediately.

The diagnostic tests for syphilis may fail more frequently (producing false positives and negatives) in people with depleted immune systems. However, these failures are still believed to occur only rarely.

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