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SafeSexGuide
SYPHILIS
SYPHILIS

Also known as: VD, Louies disease

How You Get It (Exposure):

Syphilis is a sexually transmitted infection caused by the corkscrew shaped bacteria (spirochete) Treponema pallidum. The bacteria lands on your body during sex with an infected partner. The most common sites of infection are the penis, anus or vagina. Within 90 days of infection (two to four weeks average) a red, painless ulcer called a chancre appears. The chancre, though usually singular, can be multiple, and will heal even without treatment within three to eight weeks.

Warning Signs (Symptoms):

Primary syphilis: a painless red ulcer called a chancre. Secondary syphilis: symptoms of viral illness including fever, joint pains, swollen lymph nodes. A copper-colored skin rash, particularly on your palms and soles is classic. Like the chancre, the rash also goes away even without treatment within two to six weeks. Tertiary syphilis: central nervous system damage including blindness, loss of hearing and insanity. Heart disease (destruction of heart valves) and vascular disease (aortic anneurysm) are also common.

For Men: The chancre most often appears on or close to the glans (head) of your penis. It can also be further down the shaft or on the scrotum. If you have anal syphilis, the chancre might be inside your anal opening, making it hard to spot.

For Women: Although heterosexual sex and male homosexual sex are the most common ways syphilis is spread, many lesbians have or have had sex with men. A lesbian can spread syphilis she caught from a man to her unsuspecting partner either orally or through shared toys. In the vagina, a chancre is almost impossible to spot.

Getting Checked Out (Diagnosis) / Treatment:

Some physicians use a darkfield microscope to examine a sample of fluid from your chancre. You have syphilis if they see the spirochete bacteria. Today the most common test for syphilis is a blood test that looks for antibodies to the spirochete. It is called a VDRL (Venereal Disease Research Laboratory) or FTA-ABS (florescent treponemal antibody absorption) test. Another blood test often used to confirm the presence of active infection is called an RPR (rapid plasma reagin).

Treatment for primary syphilis or syphilis of less than one year duration: Benzathine penicillin G - 2.4 million units by injection or oral doxycycline 100mg twice a day or tetracycline 500mg four times a day for 2 weeks. Syphilis infections of greater than one year duration or of unknown duration: Benzathine penicillin G - 2.4 million units by injection weekly for 3 weeks or either of the above oral medications for four weeks duration. A penicillin derivative is still the drug of choice, but doxycycline or tetracycline works well for penicillin-allergic individuals. No matter what type of syphilis you have, a critical treatment step is notification of all of your sexual partners. They must also be treated.

If Left Untreated:

For several years the untreated disease will be latent in the body without symptoms. Some advanced cases will move on to tertiary syphilis. If ignored, the disease can be fatal.

Prevention:

Although a condom will generally prevent syphilis infection, it must be worn from the start of close physical contact.

If your partner has a chancre at the base of his shaft, scrotum or pubic hair, a condom will probably not protect you. The spirochete is extremely sensitive to drying and is easily killed with soap and water. Washing up after sex will go a long way in preventing infection. Heterosexual couples in the United States are often routinely tested for syphilis as part of a marriage license procedure; gay couples, however, are presently denied the right to marry and thus often do not undergo a syphilis test. As part of prevention, we must routinely ask for syphilis screening.

Prevalence:

The Centers for Disease Control and Prevention (CDC) estimates that more than 40,000 new infections occurred last year, with at least half of them in men who have sex with men. Although physicians have been able to successfully treat syphilis, many cases still go undiagnosed.


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