Syphilis

• Sexual Health • Jul 05, 06

Syphilis is an infection caused by a spirochete, a nasty little bacteria that is shaped like a corkscrew. Only rather than popping open a bottle of Bollinger RD 1985, this bugger pops open your skin like a Miller High Life beef bong. And the hard truth about Syphilis is that you can get it without even having sex.

What is it?
Syphilis dates back to prehistoric times, and holds a prestigious place in American history as many experts have proffered that both Christopher Columbus (the explorer, not the filmmaker) and General George Washington may have had it. I guess that means if you’ve got it you’re in pretty good company. In fact you may be less alone than you thought. In Seattle/King County there were 140 cases of Syphilis reported in gay/bi men in 2004. By the end of June 2005 there were already 90 cases, more than twice that of 2004. But what’s the big deal; it’s only 100 cases, right? Considering that in 1999 there were zero cases of Syphilis, it makes this current rise of cases significant.

In fact, at the onset of the 21st century we were pretty close to eliminating Syphilis in the U.S. all together. There were less than 50 cases in less than 40 counties in 1999. But then there was an upsurge, primarily in gay/bi men, around 2000. According to the Centers for Disease Control and Prevention (CDC) over 60% of all new cases are in gay and bi men. Experts attribute this recent outbreak to increased unsafe sex and party drugs like Crystal Meth, Coke and Ecstasy. Researchers in Chicago even speculated that over 13% of their 2004 cases were spread through oral sex only. Basically, it’s a problem that isn’t going to go away any time soon.

How do you get it?
It’s passed along by contact with the Syphilis bacteria through a small, sometimes almost invisible, painless sore, usually through unprotected anal or oral sex with an infected person. Syphilis can be spread through skin-to-skin contact.

How do I avoid it?
By using condoms for anal and oral sex. In addition, taking the time to discuss STDs with your sex partners can be a way to get the information needed to decide whether or not to steer clear of transmission via skin-to-skin contact.

There are three stages to Syphilis infection:

Primary Stage - occurs about 90 days (on average about 2-4 weeks) after initial exposure a. Basically, you get a big red, painless sore called a chancre on your skin, usually at the site of infection b. The chancre oozes a lot of bacteria-filled pus, which makes you highly contagious at this stage c. Chancres can hide in your ass or mouth, and since they don’t hurt you may never notice them - you can go through this entire stage without every knowing you are infected d. Eventually, the chancre will heal over and go away - at this point the infection spreads to the rest of your body
Secondary Stage - includes fever, fatigue, joint pain, swollen lymph nodes, eye and liver trouble, and a copper-color rash a. The rash is usually found on the palms of your hands and the soles of your feet, but it can also be on your torso or other areas b. The rash is still infectious, especially if it is “weeping,” or pus is oozing from it c. The rash and other symptoms will go away by themselves, but if left untreated the infection will lead to…
Tertiary Syphilis - the symptoms for this stage can show up any time between 10-20 years after the initial infection (it will show up earlier in HIV positive men) a. After the Secondary Stage you are no longer contagious b. Syphilis attacks your brain - leading to insanity and dementia c. Syphilis attacks your heart valves, particularly your aorta d. If left untreated, Tertiary Syphilis can kill you

Testing and treatment
If you think you might have Syphilis, go to a doctor and find out for sure. Only a person with a lot of letters after their name can diagnose and treat your Syphilis. Sometimes Syphilis can hide in your ass and mouth, which is why it is important to get the blood test as part of your regular testing routine.

The good news is that Syphilis is easy to treat. Just trot on down to your doctor’s office and have him/her fill out the old Rx pad for a healthy dose of penicillin. If you’re allergic, there’s always doxycycline or tetracycline. But just because you get rid of your Syphilis doesn’t mean you can’t catch it again.

It can be hard, but you should really notify any of your sex partners that you caught Syphilis. Maybe one of them had it and didn’t know. Maybe you’ve spread it to someone else. They will undoubtedly want to know about it. The best way to avoid spreading it or catching it is to use latex or polyurethane condoms with water or silicone-based lubes for anal sex (or even for oral, there are some tasty flavored condoms and lube out there nowadays). But even this won’t keep you completely protected. Again, you can catch Syphilis just by coming in contact with somebody’s chancre sore or rash.

HIV connection?
Syphilis is especially common in men with HIV, and may be more serious in Positive guys. Everyone with HIV should have a Syphilis test, even if they have no symptoms, and all who test positive and are treated should have regular follow-up blood tests to ensure that treatment was effective. If you have had neuro-syphilis, follow-up requires a spinal tap. Ouch!