SEXUALLY TRANSMITTED INFECTIONS
Syphilis is a sexually transmitted disease (STD) caused by a type of bacteria called Treponema pallidum. It can spread from person to person by physical contact during vaginal, anal, or oral sex. Syphilis can cause serious complications when left untreated but it is curable with antibiotics.
Untreated syphilis can lead to permanent vision and hearing loss, stroke, organ damage, and in some cases, death. Studies have shown that when someone gets infected with syphilis, their chances of becoming infected with HIV in the future become much higher. Because of this, we recommend that HIV-negative people who are diagnosed with syphilis talk to their providers about taking PrEP to protect themselves from HIV.
In people who are living with HIV and who are not undetectable, syphilis can make it easier to spread HIV to their sex partners.
If a pregnant woman has syphilis, she can pass it on to her baby. This is very dangerous and can lead to the death of the baby.
The first symptoms usually show up in the first 12 weeks after becoming infected. Syphilis infection has four stages: primary, secondary, latent, and tertiary (late).
1) Primary syphilis: 1-12 weeks
The first sign of primary syphilis is often a skin sore called a chancre (shank-er). Chancres can appear on your penis, scrotum, vaginal lips, butt, or in your mouth. They are usually not painful. You may have more than one, or you may have chancres and not notice them because they are inside your anus, vagina, or mouth.
Chancres go away after several weeks even without treatment, but you will still be infected and can spread syphilis to sex partners.
2) Secondary syphilis: 1–6 months
About 25% of people with untreated syphilis will develop one or more of these symptoms, one to six months after becoming infected:
- Flu-like illness with sore throat, headache, fever and fatigue
- Skin rash that appears on your genitals, neck, torso and sometimes on palms of hands and soles of feet; usually the rash is not itchy
- Wart-like growths (condylomata lata) may appear on your genitals or around your anus
- Grayish or whitish patches on your tongue or throat
- Patchy hair loss
Secondary syphilis symptoms usually last anywhere from one to three months, but sometimes they last longer, or come and go over a year or two. Even without treatment these symptoms will go away, but you are still infected and can spread syphilis to sex partners.
3) Latent syphilis
Latent syphilis is when a person is infected but has no symptoms. The infection can be detected only by a blood test. If not treated, latent syphilis continues for life. Many people with latent syphilis never have serious problems, but some progress to the final stage, called tertiary syphilis.
4) Tertiary (late) syphilis: 1+ year
About 33% of people with untreated syphilis experience serious damage to various organs and body systems. Tertiary syphilis can appear any time from a year to 50 years after becoming infected; most cases occur within 20 years. The brain, heart, liver, and bones are the most commonly involved organs. Tertiary syphilis can cause paralysis, mental problems, blindness, deafness, heart failure, and death.
Neurologic syphilis means the syphilis bacteria has entered your nervous system.
This is very dangerous and can happen during any stage, even very early after infection. Symptoms of neurologic syphilis include:
- Vision changes
- Red and/or a painful eye
- Difficulty looking at light
- Ringing in the ear
- Hearing changes
- Neck pain and stiffness
- Nausea or vomiting
Congenital syphilis is passed from pregnant mother to baby.
Syphilis can be passed from an infected mother to her baby during pregnancy or childbirth. If the mother is not treated, congenital syphilis can lead to serious health problems for the baby, including death.
All pregnant women should get tested for syphilis at their first prenatal care visit, and again in the third trimester and at delivery if there is a chance she became infected with syphilis during pregnancy. In places with high rates of syphilis in women, the state or local health department may recommend that all pregnant women get tested for syphilis three times during pregnancy, because it can be difficult to know who is at risk. If you are pregnant and concerned about syphilis, talk to your healthcare provider or call San Francisco City Clinic at 415-487-5500.
During a complete check for syphilis our medical staff will ask you questions about your sexual history, examine any parts of your body where you might have symptoms (chancres, rash, etc.), and order a blood test. There are special tests available at San Francisco City Clinic to immediately diagnose syphilis from a chancre, if you have one.
Penicillin shots cure syphilis. If you have a serious allergy to penicillin, there are alternative antibiotics. One safe and effective alternative is a pill called doxycycline.
It is very important to have repeat syphilis blood tests after you are treated to be sure the treatment worked and the infection is completely gone. In most cases this means repeat blood tests three months after treatment, then every three to six months for the next year.
- Do not have sex for one week after treatment.
- Tell your sex partner(s) because they must be examined and treated too, otherwise they can give the infection back to you and/or infect others.
- Your syphilis blood test may stay positive even after treatment but if your treatment was completed then you no longer have the infection and you cannot infect your partners. Talk to a healthcare provider about what your syphilis test results mean.
If you're sexually active, using condoms consistently and correctly for oral, anal and vaginal sex is your best way to protect yourself from syphilis. However, syphilis can be passed even when condoms are used so talk to your clinician about whether you are at risk for syphilis.
If you’re thinking of having sex with a new partner:
1. Talk about STDs, including when each of you were last tested.
- Women up to age 25 should be tested at least annually.
- Trans women and trans men who have sex with men should be tested every three months.
- Men who have sex with men should be tested every three months.
- Men who have sex with women up to age 25 should be tested in certain situations, for instance if you’ve had one of these infections in the past, have a partner with an STD, or you live in an area where your chances of getting an STD are high.
2. Male and female condoms are effective in reducing the risk of infection.
3. Do not have sex if you or a sexual partner has abnormal discharge, burning with urination, or any other symptom that could be due to an STD.