For several decades syphilis has been relatively rare in the UK. But since 1998 syphilis infections have risen sharply, especially among gay men.
In England and Wales the number of new cases more than doubled in the year 2000. Manchester, Brighton and London were worst affected. In Manchester alone from January 1999 to mid 2001 there have been over 160 cases of infectious syphilis of which 75% were among gay men. Probably many more men have been infected but do not realise it. Syphilis cases have also risen in cities like Hamburg and San Francisco.
Glasgow has seen very few cases in recent years, but here too numbers have increased in the past two years. It is possible that some Glasgow men have acquired the infection recently while visiting the 'scene' in the south and that they may not have developed the signs of early syphilis.
This page explains more about syphilis and answers frequently asked questions about this important sexual infection.
How Can I Catch It?
Syphilis is less easy to catch than gonorrhoea or NSU, but it is much more easily caught than HIV. Syphilis spreads best by contact with moist skin anywhere on or in the body.
Some of the ways you can catch it:
- Kissing
- Sucking without using a condom
- Mutual masturbation
- Fingering
- Rimming
- Fisting
- Fucking without a condom
- Handling a used condom
In the recent outbreaks, syphilis has been more likely in people having:
- Casual sex in saunas, cruising areas and gay sex venues
- Multiple sexual partners especially at the same time
- Oral sex without using condoms
Syphilis makes HIV easier to pass on and catch, and HIV can make syphilis harder to treat.
How would I recognise it?
Early syphilis is easy to miss! Many people show no sign they are infected
You may see two stages:
- A few days after sex a small sore on the penis, mouth, anus or tongue appears. This is PAINLESS and heals up by itself
- A few days to many weeks later: a rash can develop, notably affecting the palms. Mouth ulcers occur. Moist warty lumps grow round the anus. People can feel ill and feverish.
Syphilis isn't always easy to spot because it can look like other common conditions, and it is known to fool even the experts unless the correct blood test is done.
Most people with syphilis have no visible signs. Not only is this bad for you because of damage in later life, but it means you can pass it on to others without realising you have a problem.
What is the test?
The only reliable way to tell if you have syphilis is to have a blood test. It takes about a week to process and return the results.
In the very early stage of the infection, syphilis in an ulcer can be seen under a special microscope. This test is only available at a GU Medicine clinic.
What is the damage?
Early syphilis can make some people feel very ill, especially the 'secondary stage' with a rash and fever.
Later on, syphilis can damage many organs if it remains untreated. The heart, brain, eyes, bones and nervous system can all be affected and the results can be fatal or lead to mental illness. Usually this takes 20 years or more. Adequate treatment at any time can stop further trouble, though it does not repair any damaged organs.
You usually remain infectious to other people for about 2 years from the date of getting your infection.
How can I keep safe?
Key ways to protect yourself are:
- Get a regular sexual health check and syphilis test
- Use condoms for any type of sex, even oral sex
- Reduce the number of casual partners you have sex with
- Be extra careful when having sex in places where syphilis is more common
If you develop any symptoms then seek help quickly, especially if you have noticed a sore on the genitals. The earlier syphilis is treated the better.
What is the treatment?
Syphilis is best treated by a course of penicillin injections which lasts between 10 and 17 days. Treatment should ideally be given in a clinic used to dealing with syphilis, such as a GUM clinic or (in Glasgow) the SRP. Health Advisers there are able to give you support and advice.
Where can I get Help?
If you want help from a clinic specialising in gay men's problems, come to the Steve Retson Project. It runs clinics at the Sandyford Initiative and the LGBT Centre in Glasgow.
The main genitourinary medicine (GUM) clinic in Glasgow is at the Sandyford Initiative. It runs walk-in clinics first-come first-served every weekday. Doors open at 8.30am. Appointments can also be made.
If you live outside Glasgow, your local GUM department will be able to help. Look them up in the phone book (under GUM clinic) or check on www.aidsmap.com.
Your GP can also test you for syphilis or put you in touch with the nearest GUM department.
Contact details for the Sandyford:
6 Sandyford Place, Sauchiehall St, Glasgow G3 7NB
Phone: 0141 211 8628
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