Like many other cities around the world, Perth is now experiencing a significant rise in the number of syphilis infections in men who have sex with men (in the last year syphilis diagnosis have more than tripled!!).  Because syphilis is easily treated and cured with penicillin when detected early, it is vital for men who believe they have been at risk, to seek testing through their GPs or other sexual health clinics.

So how do you know whether you are at risk? Well, the fact is that it’s easier to get and pass on syphilis than HIV, it is a bacterium contracted through giving or receiving oral, anal, or vaginal sex without condoms and arse play. As many people do not experience signs or symptoms you cannot tell if somebody has syphilis. 

However, there are some symptoms which you should keep in mind and be aware of. Some people do experience a painless red sore (called a chancre) a few weeks after exposure.  This sore can appear on their cock, arse or lip but sometimes it can be in tricky places like the mouth, throat, vagina or rectum and therefore not be easy to see.  Because it’s painless it is common not to notice it.  This sore sometimes lasts up to 3 months when it forms a scab and heals. At this stage of infection, syphilis is relatively easy to treat and cure with penicillin, which is why it is absolutely vital for syphilis to be detected and treated early.

It is important to note that after initial infection, syphilis remains in the body and may appear as a rash on the palms of the hands, soles of the feet or other parts of the body.  There may be other non-specific signs such as fever, swollen glands, sore throat and hair and weight loss.  Treatment is still available at this stage of the infection although it will be more involved than earlier. 

If left untreated, syphilis can go on to cause serious damage to the body’s internal organs including the brain, nerves, eyes, heart, liver, bones and joints. The damage may be so serious as to cause death (for literature and music buffs – Karen Blixen and Mozart both died of complications related to tertiary syphilis).  At this stage, syphilis becomes difficult or impossible to treat and the damage to organs is irreversible. How do you make sure you don’t get to this stage of syphilis? Test regularly (at least once a year) so that you can be treated and cured if infected.

The treatment of syphilis is potentially more complicated for people with HIV. There has been some evidence of syphilis progressing more quickly in HIV positive individuals, for example, the rash (usually seen in secondary syphilis) can sometimes emerge more rapidly while the chancre (painless button-like sore or ulcer) is still present. Syphilis also makes it easier to contract or pass on HIV, especially while the chancre is present.

The only way to know for sure if you have syphilis is to get a blood test.  Syphilis has a window period, so if you are at high risk (for example you’ve had sex with someone who has syphilis or had many multiple casual partners) you will probably need more than one test over a period of three months.

For most sexually active people a yearly, half yearly, or quarterly testing depending on your number of sexual partners, is advisable. Tests for syphilis and other STIs are available at Sexual Health Clinics at Royal Perth Hospital and Fremantle Hospital, WA AIDS Council, FPWA, GPs, and at the Sauna Sexual Health Clinics at Perth Steamworks and Beaufort 565. Call the Western Australian AIDS Council on 9482 0000 or Contact Us for more information.

- Ben Bradstreet
Sauna Outreach & Community Development Officer
Community Education & Prevention Services
WA AIDS Council