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    Syphilis and Men Who Have Sex With Men

    What Is Syphilis?

    Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum . It has often been called "the great imitator," because so many of the signs and symptoms of syphilis are indistinguishable from those of other diseases.

    How Is Syphilis Spread?

    The syphilis bacterium is passed from person to person through direct contact with a syphilis sore (also called a chancre). Sores occur mainly on the external genitals, in the vagina, on the anus, and in the rectum. Sores also can occur on the lips and in the mouth (areas covered by mucous membranes). Transmission of the bacterium occurs during vaginal, anal, or oral sex. Persons with either primary or secondary syphilis (in the early stages) can transmit the disease. Pregnant women with the disease can pass it to the babies they are carrying. Syphilis cannot be spread through casual contact, such as with toilet seats, door knobs, swimming pools, hot tubs, bath tubs, shared clothing, or eating utensils.

    Why Should Men Who Have Sex With Men Think About Syphilis?

    Over the past several years, increases in syphilis among men who have sex with other men have been reported. In the recent outbreaks, 20% to 70% of cases occurred in men who also have HIV. While the health problems caused by syphilis in adults are serious in their own right, it is now known that the genital sores caused by syphilis in adults also make it easier to transmit and acquire HIV infection sexually. In fact, there is a two- to five-fold increased risk of acquiring HIV infection when syphilis is present.

    Syphilis Symptoms

    Primary Stage

    The primary stage of syphilis is usually marked by the appearance of a single sore, but there may be multiple sores. The duration between infection with syphilis and the onset of the first symptoms can range from 10-90 days (average 21 days). The sore is usually firm, round, small, and painless. It appears at the spot where the syphilis bacterium entered the body. The sore generally lasts three to six weeks, and it heals with or without treatment. However, if adequate treatment is not administered, the infection can progress to secondary syphilis.

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