Syphilis

Every year, nearly 9 million people under the age of 25 get a new STI (sexually transmitted infection).¹ One of these infections is syphilis. If you've had sex, you could have an STI. Some STIs cause symptoms. Others don't. You could have one and not even know it. Some STIs make you sick today and others cause problems later in life. These include serious problems like cancer or infertility. Some can even kill you.

What is syphilis and how do you get it?
Syphilis is a bacterial STI. You get it from having sex with an infected person. You usually get it through contact with sores or infected patches. These can be on the genitals, on skin near the genitals, or sometimes even on the mouth. Babies can get it from their mothers during pregnancy. Many infected people don't notice any symptoms, but they can still pass on syphilis.

Am I safe if I only have oral or anal sex?
Syphilis can be passed through contact with infected skin and during oral or anal sex.^2,3

What happens if I'm infected?
Syphilis symptoms are often similar to those of other diseases. At first, you may get a painless sore for a few weeks. If you don't get treatment, your syphilis will get worse. Next, you may feel like you have the flu. At this point, you may notice a rash. If you still don't get treated, syphilis can cause blindness, brain damage, heart damage and death. If you are pregnant, you can have a miscarriage or a stillborn baby. A baby born with syphilis can have serious birth defects.² Syphilis may also increase your chance of getting HIV.⁴

How do you treat syphilis?
Syphilis can be treated with antibiotics. However, they will not repair any damage already done. Delayed treatment can result in serious problems. You and your recent partners must be treated.⁵

Am I safe if I always use a condom? If you always use condoms for vaginal sex, you can cut your chance of getting syphilis by about half.⁶ So far, there is no evidence that condoms reduce your chance of getting syphilis during oral or anal sex.

What can I do to avoid getting infected?
Avoid sexual activity if you are single. Be faithful to one uninfected partner for the rest of your life. Already had sex? See a doctor and get checked.

References
1 Weinstock H, Berman S, Cates W Jr. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health; 2004;36(1):6-10.
2 Sparling PF, Swartz MN, Musher DM, Healy BP. Clinical Manifestations of Syphilis. In: Holmes KK, Sparling PF, Stamm WE, et al., eds. Sexually Transmitted Diseases. 4th ed. New York, NY: McGraw Hill, Co.; 2008:661-84.
3 Centers for Disease Control and Prevention (CDC).Transmission of primary and secondary syphilis by oral sex--Chicago, Illinois, 1998-2002.MMWR Morb Mortal Wkly Rep. 2004 Oct 22;53(41):966-8.
4 Sexton J, Garnett G, Rottingen JA. Metaanalysis and metaregression in interpreting study variability in the impact of sexually transmitted diseases on susceptibility to HIV infection. Sex Transm Dis 2005;32(6):351-7.
5 Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2006. MMWR 2006;55(No. RR-11):1-94.
6 Ahmed S, Lutalo T, Wawer M, et al. HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai, Uganda. AIDS. 2001;15(16):2171-2179.

Authored by: Sheetal Malhotra, MBBS, MS
Date: May 2007
Reviewed by: Kate Hendricks, MD, MPH&TM
Date: May 2007
Revised by: Jennifer A. Shuford, MD, MPH
Date: December 2009