Syphilis: What it is and When to Get Tested

When thinking about sexually transmitted infections (STIs), people often remember HIV, chlamydia, and gonorrhea from sex ed. But there is another player in the game that has been around for centuries and has had quite a resurgence across the country: syphilis. 

If your first thought is "Wait, isn’t that a Victorian-era disease?", you aren't alone. But syphilis is very current. The good news? It is 100 percent curable. The even better news? It’s super easy to test for. 

What is syphilis? 

Syphilis is a bacterial infection caused by Treponema pallidum, usually spread through vaginal, anal or oral sex, but which can also be transmitted through close skin to skin contact. It’s a bit of a shapeshifter, which is why you might hear it called "The Great Pretender." Its symptoms can look like a dozen other things—or it might show no symptoms at all for years. 

Because it moves in stages, it’s important to recognize the "vibe" of each phase: 

• Primary Stage: This usually involves a single sore (called a chancre). It’s typically firm, round, and painless. Because it doesn’t hurt and can hide in places like the rectum or the folds of the labia, it can be easy to miss! 
• Secondary Stage: You might develop a skin rash, swollen lymph nodes, or a fever. Again, it’s easy to mistake this for a weird flu or an allergic reaction. In some cases, the bacteria can enter the central nervous system causing headaches, vision changes, and stroke-like symptoms. 
• Latent Stage: This is the "quiet" phase. The bacteria are still in your body, but you have no symptoms. This can last for years. 
• Tertiary Stage: This is rare and only happens if the infection goes untreated for decades, potentially affecting the heart, brain, and nervous system. 

Why we need to talk about inclusivity and sexual health 

Sexual health doesn’t discriminate, but the way we talk about it should be inclusive of everyone. Whether you are straight, gay, bi, trans, or queer, your sexual health matters. 

Statistically, we have seen higher rates of syphilis within the LGBTQ+ community, particularly among men who have sex with men (MSM). However, it is vital to remember that syphilis is not a "gay disease." It is a human infection. Inclusive care means having a provider who respects your identity, understands your specific needs, and provides a safe, judgment-free space for testing and treatment. 

Pro-Tip: Syphilis isn't always included in a "standard" STI panel. If you’re getting checked, specifically ask your provider: "Can we include a syphilis screen in my bloodwork today?". There are also some new over the counter home test kits for syphilis for folks to use who have never had syphilis in the past. 

When should you get tested? 

Testing recommendations change based on a number of factors. 

• Once a year if you are in a monogamous relationship. 
• Every 3–6 months if you have multiple or anonymous partners. 
• Whenever you have a new partner or notice a weird bump or rash. 
• If you are pregnant. Syphilis infections can be passed on to a baby causing “congenital syphilis.” 
• If you have been treated for syphilis in the past you should be tested once a year to monitor your labs. 
• If you are sexually active, getting tested is simply a part of a self-care routine. 

Syphilis treatment: the easy part 

If you test positive, take a deep breath. It is not a reflection of your character; it’s just biology. Syphilis is treated with antibiotics prescribed by your healthcare provider. Penicillin is often prescribed, though the dosage and duration of treatment varies depending on the stage of the infection. 

It is important to finish the full course of treatment as prescribed by your provider. Also, you'll need to notify your recent partners so they can get tested too. It can be an awkward text to send, but it’s an act of care that stops the cycle of infection. 

Staying safe 

Preventing sexually transmitted infections doesn’t have to be clinical or boring. It’s about boundaries and protection for you and your partner. Some ways to prevent the spread of infections include: 

1. Barrier Methods: Condoms and dental dams are your best friends. They significantly reduce the risk of transmission. 
2. Doxy PEP: Currently suggested for folks who have multiple sexual partners and have been diagnosed with an STI in the past. Taking two pills (200mg) of doxycycline after or up to 72 hours after an unprotected encounter can significantly reduce your risk of syphilis infection. 
3. Communication: Talking to your partners about when you were last tested. 
4. Regular Screens: Make it a habit! 

Syphilis might be an old-school name, but don't let fear or stigma keep you from getting tested. By staying informed, getting tested, and treating ourselves and our partners with respect, we keep our community vibrant, healthy, and informed. 

Come see us at the Corliss Clinic to get tested and learn about ways to stay healthy.