What is it?


Syphilis is a bacterial infection that infects the penis (dick), throat or anus (bum) and then spreads to different parts of the body through the bloodstream. If left untreated syphilis can cause damage to the nerves, bones, skin, eyes, and brain.


How do you get it?


Having vaginal, 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. If untreated, syphilis progresses through three stages, each of which has different symptoms.


Stage 1 (primary syphilis):

A painless red sore (chancre) can appear on your penis (dick), balls, mouth, throat or arse that turns into a scab and then heals. It usually appears at the site of infection. This stage may show up 10 to 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 (secondary syphilis):

A rash may 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 two to six months after the after initial infection and last for six months or longer. Usually after this stage syphilis becomes latent (no symptoms) for a long period but may eventually progress to stage 3.


Stage 3 (tertiary syphilis):

If untreated, syphilis remains in your body and may begin 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. For people who are very sexually active with more than one partner, regular testing (every three months) is now recommended.


Can it be treated?


Syphilis can be treated with a single injection of penicillin in the early stages, or with a course of antibiotics in later stages. 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 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. Nervous system complications can occur is the early stages of infection in people with HIV—not just 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 (infection of the brain) 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 highly depleted immune systems. However, these failures are still believed to occur only rarely.