Syphilis

Syphilis is a sexually transmitted infection (STI). It is a bacterial infection. Having syphilis can increase your risk of getting HIV, the virus that causes AIDS. It can also increase your risk of spreading HIV to other people. Left untreated, syphilis can cause heart and nerve damage. It can also lead to death. Pregnant women who have syphilis can infect their unborn babies. This can lead to deformities or even the baby's death.

Syphilis rates are increasing in every part of the U.S. Health experts are particularly concerned about:

• Continued high rates among gay and bisexual men.
• The increase in babies born with the disease (congenital syphilis).

Syphilis gets worse in stages. The symptoms early in the disease may be very mild. Between stages, you may not have any symptoms or may not even notice them.

Stage 1 or primary syphilis: A painless sore on the genitals, anal skin, or mouth. The sore goes away in 3 to 6 weeks.

Stage 2 or secondary syphilis: A rash, fever, sore throat, muscle aches, extreme tiredness (fatigue), and other flu-like symptoms. These symptoms often are severe enough that the person gets medical care. If they are mild, or not brought to attention, they will also go away over time. But the infection is still there. You may have no other symptoms until serious problems occur.

Stage 3: Late syphilis. This often occurs years or even decades later. Symptoms can include nerve or walking problems, paralysis, a change for the worse in your mental state, damage to your heart or blood vessels, seizures, blindness, or death.

Syphilis is treated with antibiotics. It's often treated with shots of penicillin. The shots may be given once. Or you may get them weekly for 3 weeks depending on your stage of disease. In people allergic to penicillin, syphilis may be treated with doxycycline or other antibiotics taken by mouth for up to 1 month. More severe infections may need IV (intravenous) penicillin.

During treatment, it's important not to have sex, or you may infect someone else. See your health care provider for follow-up visits. This lets your provider check to make sure the syphilis is cured. Your partner should also be checked for the infection. Syphilis can be cured with the right antibiotics. But treatment won't fix any damage that the infection has caused.

As with all STIs, knowing your partner's sexual history is a big step toward preventing syphilis. You should also know the signs and symptoms of the infection. And use latex condoms to reduce your risk.

If you are a gay or bisexual man who is sexually active:

• See your health care provider. Tell your provider about your sexual history. Ask to be tested for syphilis and other STIs.
• Get tested. Get a syphilis test at least once a year. Get tested more often if you are at risk. Often there are no symptoms. So testing is the only way to know for sure that you don't have syphilis.
• Have one partner. It's safest to be in a long-term relationship with only one sex partner. Your partner should be tested and have negative STI test results.
• Use latex condoms. It's important to use latex condoms the correct way each time you have sex.
• If you have multiple sex partners, get tested again. Even after you've been successfully treated for syphilis, you can still be reinfected.

If you are pregnant:

• See your health care provider. Tell your provider about your sexual history and STI testing.
• Get tested. Get a syphilis test at your first prenatal visit. You may also need to be retested during your third trimester and at delivery if you are at risk.
• Know your test results. If you test positive for syphilis while you are pregnant, get treatment right away.
• Have one partner. It's safest to be in a long-term relationship with only one sex partner. Your partner should be tested and have negative STI test results.
• Use latex condoms. Whenever you have sex, use latex condoms the correct way.
• Go to follow-up visits. Keep seeing your provider during your pregnancy. If you learn that a sex partner has or may have syphilis, tell your provider. Your partner should be treated, too.

American Sexual Health Association STD Hotline, www.ashasexualhealth.org , 919-361-8400

CDC, www.cdc.gov/std, 800-232-4636