What is syphilis?

Syphilis is a sexually transmitted disease (STD) caused by a type of bacteria called Treponema pallidum.

How many gay men in Seattle have it?

Syphilis has made an astounding comeback in Seattle and King County — an 82 percent increase from 2009 to 2010, with 9 out of 10 cases showing up in gay and bi men. During the first three months of 2011 syphilis cases are double what they were this time last year. Syphilis was almost eliminated in gay and bi men in King County in the early 1990s. Now we have more cases of syphilis in a year than new diagnoses of HIV! And syphilis is 15 times higher in gay/bi men who are living with HIV than in gay/bi men who do not have HIV.

What are the symptoms?

Symptoms are easy to miss, and easy to mistake for something else. Even if you don’t notice symptoms, you can still have syphilis. Each stage of syphilis looks different.

Primary Syphilis

The first symptom of syphilis is a raised sore called a chancre. It usually shows up on the genitals, mouth, or rectum one to three weeks after exposure. The sore is painless, but DON’T IGNORE IT! It can last for several weeks and go away by itself. When the sore goes away, it doesn’t mean that syphilis is gone. Without treatment, it will progress to the next stage. Click here to see photos of chancres. Check out photo’s on site.

Secondary Syphilis

This stage usually starts with a reddish-brown, spotted rash on one or more areas of the body. Most often the rash appears on the palms of the hands or soles of the feet. It can also show up elsewhere on the body. The rash usually does not itch. Sometimes it’s very subtle. The rash can appear as the chancre is healing or many weeks after the chancre has gone away. It may come and go for up to two years. Other symptoms may include swollen lymph nodes, fever, fatigue, patchy hair loss, weight loss, and headache. These symptoms usually last from 2 to 6 weeks and will clear up on their own. If not treated, syphilis will still be present. Click here to see photos of syphilis rashes.  Check out photo’s on site.

Latent Syphilis

The latent stage of syphilis begins when secondary symptoms go away. During this stage there are no signs or symptoms. The infection can be detected only by a blood test. A relapse of secondary syphilis can occur during the first two years of latency. If not treated, latent syphilis continues for life and may progress to the final stage.

Tertiary (Late) Syphilis

About one-third of people who don’t get treated suffer serious damage to the brain, nervous system, heart, or other organs. Tertiary syphilis can cause paralysis, dementia, blindness, deafness, heart failure, and even death. Treatment at this stage will cure the disease and stop future damage. But it cannot repair or reverse damage that has already occurred.

How do you get syphilis?

Syphilis is usually passed from person to person through direct contact with a syphilis sore during oral, vaginal or anal sex. Because syphilis sores can be hidden in the vagina, rectum or mouth, it may not be obvious that a sex partner has syphilis. A pregnant woman can also transmit syphilis to her unborn baby. This is called congenital syphilis. If you want to know about congenital syphilis, click here.

How can I protect myself from getting syphilis?

The only sure way to avoid syphilis and other STDs is to not have sex (abstinence). If you do have sex:

  • Have sex with one partner (monogamy) who is not infected and has sex only with you.
  • Talk with your partner(s) about syphilis and other STDs. Work out a plan to reduce risk that feels comfortable for you both.
  • Have sex with fewer people. More partners = more risk.
  • Use condoms the right way every time you have sex. Condoms must cover the actual sores to prevent transmission. A condom can protect the penis, anus and vagina. But a condom may not keep you from touching sores on other body parts such as your partner’s balls, scrotum or inside his mouth.
  • Don’t have sex if you see an unusual sore or rash on your body or your partner’s body.

Information worth repeating:

You can get syphilis sores in your mouth or throat. You may not see them. They are not painful. SYPHILIS IS EASY TO GET THROUGH ORAL SEX! If you’re having sex, any kind of sex, it’s important to get tested for syphilis and other STDs regularly.

Is there a cure for syphilis?

Yes. Proper treatment will cure syphilis. It’s usually treated with a single shot of a high powered antibiotic. See a health care provider for an exam and tests to figure out the best treatment for you. After treatment, get a follow-up exam to make sure the treatment has worked.

If you have syphilis, tell each of your sex partners so they can get treated also. Do not have sex with a partner who has syphilis until he or she completes treatment.

You can get infected with syphilis again after you’ve been cured. It’s important for your partners to get treated so they won’t re-infect you.

What about HIV?

Over half of local syphilis cases are in men who have HIV. If you have HIV, syphilis can cause more harm.

  • If you already have HIV, it can be easier to get syphilis. If you get syphilis, your HIV may make it easier to transmit both HIV and syphilis to others.
  • Having HIV may make syphilis progress more quickly.
  • If you have HIV, it may take longer to treat and cure syphilis.
  • If you don’t have HIV, having syphilis or another STD can make it easier to get HIV.

Getting treated for syphilis can help you stay healthy and reduce the likelihood that you’ll pass syphilis to sex partners.

If you have HIV and are sexually active, it’s especially important to get tested regularly for syphilis and other STDs.

If you don’t have HIV, get tested regularly for HIV and other STDs.

For more information on the connection between HIV, syphilis and other STDs, click here.

What’s the test for syphilis?

It’s a simple blood test. If you’re sexually active, you can make syphilis testing part of your routine, just like testing for HIV and other STDs. If you already have HIV and are sexually active, get tested regularly for syphilis and other STDs.

How often should I get tested for syphilis?

At least once a year if you’re sexually active. Public Health also recommends that you get tested for gonorrhea, chlamydia and HIV (if you don’t already have it) at least once a year. If any of the following apply to you, you should get tested for syphilis every 3 months:

  • You have had chlamydia, gonorrhea or syphilis in the last year.
  • You used methamphetamine or poppers in the last year.
  • You had 10 or more sex partners (oral or anal) in the last year.
  • You’ve had anal sex without a condom with partners whose HIV status is different than yours or whose HIV status you do not know.

Where can I get tested?

If you think you might have syphilis, get tested at your local STD clinic or at your doctor.

Testing options in King County:

Your primary care provider or health maintenance organization (HMO).

Most private providers and HMOs provide testing and care. Cost varies.

Public Health STD Clinic

Harborview Medical Center
Ninth and Jefferson Building
908 Jefferson St, 11th Floor
Seattle, WA
Phone: 206-744-3590

M, W, Th, F 8:00am-6:30pm

T 9:30am 6:30pm

Walk-ins welcome before 4:00pm. If after 4:00, call to see if you can still be seen.

Gay City Health Project

511 East Pike

Seattle, WA

Phone: 206-860-6969

Tuesday – Friday 3:00-8:00pm

Sunday 1:00-5:00pm

Appointments recommended.

For more information and other locations, call 206-296-4649 or click here.

If you are sexually active and you notice a sore or rash

(or any other syphilis symptoms)


Syphilis is curable.

And it’s easier to treat the earlier it’s caught!

Take the Syphilis in Seattle Quiz . . . THEN GET TESTED!

1. What is one of the first symptoms of syphilis?

A sore

A drip from your penis

Itchy pubic hair


An open sore on your penis, butt, or in your mouth is usually the first symptom of syphilis. A drip from your penis could be another STD like gonorrhea. Itchy pubic hair? Could be crabs!

2. Syphilis sores are usually painful.




False – syphilis sores are usually NOT painful. They can show up on your penis or balls 1-3 weeks after you get infected. They can also be in areas that are hard to see, like inside your butt, mouth or throat. This makes them easy to miss.

3. So, if you missed the sore, what symptom comes next?

Burning feeling when you pee

Rash on your palms or bottoms of your feet

A drip from your penis


This one’s hard to miss: secondary syphilis usually shows up as a rash on the palms of your hands or the soles of your feet. But it can also show up on other parts of your body. If you see a new rash, a call to your dermatologist probably isn’t the best first response.

4. Which of these tests is used to diagnose syphilis?

A saliva test

A urine test

A blood test

Answer: It’s a simple blood test. For information on where to get tested, call 206-296-4649, or click here.

5. You won’t get syphilis if you use condoms.



Answer: False – Condoms reduce the risk of getting all STDs, including syphilis. But all it takes to get syphilis is contact with a syphilis sore. These sores are sometimes in parts of the body that a condom won’t cover.  Syphilis sores can be hard to see in the mouth or throat. This makes it very easy to get syphilis through oral sex.

6. Syphilis is like HIV: something we just have to live with.




ABSOLUTELY FALSE! – Syphilis was almost eliminated in gay and bi men in King County in the early 1990’s. It’s easy to get, but it’s easy to cure. We really can get rid of it again. GET TESTED!

7. If left untreated syphilis can cause (check all that apply):



Nerve damage

Hearing problems


Answer: All of these are possible outcomes of untreated syphilis. And none of them are pleasant. Why wait? Get tested. Today.

8. You should get tested for syphilis every 3 months if (check all that apply):

  • You’ve had chlamydia, gonorrhea or syphilis in the last year.
  • You used methamphetamine or poppers in the last year.
  • You had 10 or more sex partners (oral or anal) in the last year.
  • You’ve had anal sex without a condom with partners whose HIV status is different than yours or whose HIV status you do not know.

Answer: All of these are reasons to get tested every 3 months.

The good news: If you get syphilis, it can be cured.

The not so good news: Once it’s been cured, you can get it again.

So it’s important to keep testing regularly.

Editors Note: STD Facts can be found here.  And although we are all about stopping the rise of  Syphilis, this was a paid project.

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