Syphilis is passed through contact with sores or rashes during oral sex, anal sex, and anal play.  It can also be passed on through infected semen and other infected bodily fluids by someone who may have no visible symptoms at all. Once infected a person can remain infectious for up to 2 years.

Whilst some people may not notice any symptoms, the Syphilis infection can generally be divided into 3 separate stages that intensify as the infection progresses

Stage 1: 10 – 90 days after infection a sore (called a chancre) will show up at the site of the infection, usually on your penis, testicles, mouth, throat, or anus.  This sore may be painless and can easily go unnoticed.  This sore will eventually disappear and the infection will move into stage 2.

Stage 2:  2- 6 months after infection some guys will develop a rash on their hands, feet, or body.  Other possible symptoms in stage 2 include fevers, swollen glands, sore throat, patchy hair loss, headaches, weight loss, fatigue, and muscle and joint aches.  These symptoms may disappear within a few weeks, after which you experience a latent (hidden) phase with no symptoms, which can last for years. After this, Syphilis can progress to its third stage.

Stage 3: About one-third of people with untreated Syphilis will progress to this stage.  Syphilis will start to target the bodily organs including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.  This damage may not show up for many years and can be quite serious. 

A blood test or a finger prick test is the usual way to detect if you have syphilis, however, it may not show up in your blood for 3 months after the initial infection. If there is an open sore present, a swab from this may be able to detect the condition earlier.  Syphilis can be treated and cured with antibiotic injections.  Once somebody has had syphilis it will continue to show up as a positive in future blood tests, even if they have been treated and cured.  There are different tests to identify new infections so always remember to tell your nurse if you have had syphilis in the past so that they can do the correct tests on your blood.

Avoid contact with any rashes and sores.  Only areas covered with gloves, condoms, and dams are protected from syphilis, so wrap up and get tested regularly.  This is one bacterial infection you do not want to mess with.

If you are HIV positive, it is recommended that you get tested for Syphilis every 3-6 months when you get your bloods done.  Co-infection with HIV and Syphilis comes with increased complications.  It can reduce your CD4 count and increase your viral load, which is particularly concerning for guys with an already low CD4 count.

Syphilis can progress at a faster rate for people living with HIV and can often be mistaken for other infections found in people living with HIV.  Syphilis can affect the nervous system in people living with HIV in months rather than the years or decades it can take for those not living with HIV.  Guys with HIV can progress to Neuro Syphilis despite standard treatment. Careful monitoring is strongly advised.