Mature couple stopping to play with their dog while walking down a neighborhood street

Syphilis: Get the care that fits you

The rate of syphilis has been rising dramatically among gay, bisexual, and/or men who have sex with men. Here’s what you need to know about this common STD/STI.

Syphilis: Get the care that fits you

The majority of syphilis cases in Massachusetts and the U.S. are among gay, bisexual, and other men who have sex with men, including men older than 50. Here are a few things you should know about this common STD/STI.

What is syphilis?

Syphilis is a sexually transmitted disease caused by bacteria. Any sexual skin-on-skin contact with someone who has infectious syphilis can result in transmission.

The first sign of infection takes the form of a sore that appears on the body part that came in contact with the infection. Since the sore is usually painless, it can go unnoticed especially if it appears inside the mouth, anus, or vagina. If left untreated, the sore may last for several weeks then eventually disappear. In other instances, a rash may appear on the palms of your hands, bottoms of your feet, torso, or other part of the body.

The symptoms of syphilis will eventually go away, but if it’s left untreated the bacteria remain active in the body and can lead to serious health problems, including blindness, dementia, and damage to the heart.

The average time between infection and symptoms is approximately 21 days, yet symptoms can occur as early as 10 days or as far out as 90 days after infection. It’s possible for someone to have syphilis for years and not know it. The only way to know if you have syphilis is to get tested.

Recently, there has been a reported increase in ocular syphilis, a condition in the eye that can cause changes to vision. Ocular syphilis can occur at any time if a person has untreated syphilis. Symptoms include seeing “floaters,” blurry vision, and a serious eye infection called uveitis. If you’re experiencing these or other symptoms, it doesn’t mean you have ocular syphilis. However, you should visit your doctor right away to get tested and treated.

How can I prevent syphilis?

Since the sore caused by syphilis is usually painless and often not visible, it’s very possible that neither you nor your partners would notice it.

Condoms are a good method of protection against syphilis (and other STDs/STIs), but they aren’t a surefire solution since a condom can’t cover everything. That’s why it’s important to get tested regularly for syphilis, even if you use condoms—and especially if you have any sexual skin-on-skin contact involving the penis, scrotum, anus, mouth, or vagina.

Syphilis Testing

A simple blood test can detect syphilis. Your health care provider may also examine you for sores or rashes to help determine if you have the infection.

When should I get tested?

Are you sexually active? STDs/STIs are a risk at any age if you’re sexually active with more than one partner or if you and your partners haven’t been tested regularly. If you think you’ve been exposed to syphilis or another STD/STI, or if you have symptoms, see your provider right away to get tested. Providers will often test for HIV at the same time, since having syphilis increases your chances of HIV infection. Nearly half of gay, bisexual, and/or men who have sex with men that test positive for syphilis also have an HIV infection.

Be sure to tell your provider if you’ve had sex with someone who was recently diagnosed with syphilis. If you’ve been exposed to syphilis within the last three months, your provider will likely prescribe antibiotics regardless of your test results. It may be possible that you are infected but it’s too early to detect infection. If left untreated, you may experience symptoms later and possibly pass the infection to someone else.

Health care providers may not think to ask if you’re sexually active or the type of sex that you’re having, especially if you are over 50. But you know your sexual activity best, so be sure to ask for STD/STI testing if you think you may be at risk. Depending on your insurance, you may have additional coverage that can help cover any costs. Review your coverage to see what your options are.

Treatment for Syphilis

While an antibiotic injection can cure syphilis, it won’t prevent you from getting syphilis again, so be sure to use condoms and get tested often as a part of your self-care routine.

When syphilis goes untreated, it can progress to a bacterial infection of the brain or spinal cord called neurosyphilis. While the infection can be treated intravenously with an antibiotic, any damage it has already caused to your heart or brain could be permanent.

One of the best ways of preventing syphilis—and getting infected again—is to get your sexual partners tested and treated, too. The Partner Services Program (PSP) can help you do that. PSP helps people diagnosed with HIV and other STDs/STIs get treatment, notify partners, and even help partners get testing and medical care. PSP will never share your name with any partner you choose to notify. To learn more, visit the PSP site or call (617) 983-6999.