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Underneath the t-shirt
are syphilis rashes.

It's not a good look.

Underneath the t-shirt are syphilis rashes. It's not a good look.

Even if you don't have symptoms, you could still have syphilis. Stay healthy and active.
Get checked for syphilis.

What is Syphilis?

Syphilis is a sexually transmitted disease caused by bacteria. It's passed by contact with an area of infected skin or mucous membrane.
Syphilis goes through several stages: primary, secondary, latent and late (or tertiary). Each stage has its own signs and symptoms.

Syphilis in New York

Between 2010 and 2014, the number of New Yorkers newly infected with syphilis has increased by more than 160%. About 3 out of 4 cases are among gay and bisexual men and other men who have sex with men. Between 2013 and 2014 alone, cases in many Central NY and Capital District counties have more than doubled. Other counties across NY have also seen more cases.

Do I Have It?

You know your body well. If something is not right, you know it first. Be mindful of changes with your body—check for sores or rashes and be aware of sores on your partner. These are the first visible signs of infection and can appear on the penis, anus, or inside the mouth or rectum.

There are different stages of syphilis, each with different signs and symptoms. Although rare in early infection, serious organ damage can occur at any stage:

Primary syphilis

Painless open sore(s) on the penis, scrotum or anus, or inside the rectum or mouth.
Sores appear 10-90 days after exposure.
Sores are very infectious.
Sores go away in 3-6 weeks, even without treatment.
Without treatment the person can easily infect others, even after the sores heal.

Secondary syphilis

Rough, reddish-brown rash, usually on the palms of the hands or soles of the feet. The rash can also appear on the chest or neck. It can be very faint, and usually does not itch.
Other symptoms include flu-like symptoms (swollen glands, headache, fever, tiredness) and patchy hair loss.
Symptoms go away over time, even without treatment.
Without treatment, the person can still infect others.

Latent syphilis

After secondary symptoms go away, the person is still infectious for the first year or so after infection.
Even with no symptoms, the person is still infected and needs treatment.
This stage can last for many years.

Late syphilis

Long-term infections can cause permanent organ damage.
Syphilis can affect the brain, nervous system, heart, and other organs.
Organ damage can lead to blindness, deafness, paralysis and decreased mental functions.
Rarely, syphilis infection can lead to death.

How is Syphilis Diagnosed?

Syphilis is most often diagnosed with blood tests.

A syphilis test takes a vial of blood. Laboratories look for two things:

Your body’s immune response specifically to syphilis bacteria (antibodies)
A more general reaction to syphilis.

Together, this information helps to determine if someone has a new syphilis infection.

A rapid syphilis test is available for use in community settings. This test uses a small sample of blood from the finger. It detects antibodies to syphilis. It is a screening test, and is less effective than standard blood tests at detecting newer infections (primary syphilis). It can’t tell a new infection from a previous, treated infection. A positive rapid test must be followed by a standard blood test to confirm diagnosis.

How is Syphilis Treated?

Syphilis is easily cured with an injectable form of penicillin (an antibiotic). If a syphilis infection is not treated early and lasts for a year or longer, the person will need more than one injection.

The antibiotic kills the bacteria and prevents further damage. It doesn’t reverse organ damage that has already occurred.
There are other treatments for people who are allergic to penicillin and not pregnant.
Anyone treated for syphilis should not have sex for at least seven days after all sores or rashes have healed, and at least seven days after treatment.

Syphilis and HIV

If you are HIV negative...

Syphilis causes open sores. If you're exposed to HIV while you have sores, the risk of an HIV infection increases. Anyone diagnosed with syphilis should also be tested for HIV. HIV-negative people diagnosed with a new syphilis infection should seek education on PrEP. Anyone at high-risk for HIV can benefit from prevention services, routine medical care, access to condoms, and ongoing screenings.

If you are HIV positive...

Someone with both HIV and syphilis is more likely to transmit HIV to sex partners. Anyone with HIV who is sexually active should be tested for syphilis at least annually, and more frequently depending on their sexual practices.

I'm on PrEP, Do I Need to Worry About Syphilis?

Yes. PrEP is used to prevent HIV. It does not protect against syphilis and other STDs. In addition to routine STD screening, PrEP users at risk of syphilis or other STDs should use condoms to reduce their risk.

High-risk HIV-negative people diagnosed with a new syphilis infection should receive education and referral for PrEP. Those at high-risk for HIV can benefit from linkage to prevention services, routine medical care, access to condoms and ongoing screenings.

How Can I Prevent It?

Remember, having syphilis once does not prevent someone from getting re-infected. It’s important to take steps to reduce your risk of infection or reinfection. These are the steps you can take to reduce the risk of getting syphilis, other STDs or HIV:

Use condoms or other latex barriers (dental dam, female condom) consistently and correctly. A barrier should be put on before any oral or genital contact takes place.
Have sex with only one uninfected partner (who only has sex with you).
Get tested for syphilis and other STDs before having sex with a new partner.
HIV negative gay or bisexual men and other men who have sex with men should get tested at least annually.
HIV negative PrEP users and HIV+ persons should get tested at least every 6 months.