Late last year, WA AIDS Council released an article to inform men who have sex with men in WA that there had been an increase in syphilis amongst the gay community. Well, the response was overwhelmingly good, and many of you guys showed your concern for yourself and partners by going along and getting tested. Unfortunately, it is not over yet. We are still experiencing a steady and significant rise in diagnoses in WA. In the first quarter of 2007, the cases of syphilis doubled compared to the same period in 2006. Part of this rise is due to people doing the right thing and being tested, however, with more syphilis being reported in our community, it is important that we also test and treat people outside of the initial group who tested positive for syphilis. It is likely that there are other groups of guys who have contracted the virus and passed the infection on.
So how do you know whether you are at risk? Well, the fact is that it is easier to contract and pass on syphilis than HIV. It is a blood borne bacterium contracted through giving or receiving oral or anal sex without condoms and arse play such as rimming. Most men do not use condoms for oral sex. The fact is if you are sexually active, you may have been exposed to syphilis. As many men do not experience signs or symptoms, you cannot tell if somebody has syphilis.
However, there are some symptoms which you should keep in mind and be aware of. Some men do experience a painless red sore (called a chancre) a few weeks after exposure. This sore can appear on their cock, arse or lip but sometimes it can be in tricky places like in the mouth, throat or rectum, and therefore not easy to spot. Because it is painless, it is common not to notice it. This sore sometimes lasts up to 3 months when it forms a scab and heals. At this stage of infection, syphilis is relatively easy to treat and cure with penicillin, which is why it is absolutely vital for syphilis to be detected and treated early. Treatment can potentially be more complex for people with HIV.
It is important to note that after initial infection, syphilis remains in the body and may appear as a rash on the palms of the hands, soles of the feet or other parts of the body. There may be other non-specific signs such as fever, swollen glands, sore throat and hair and weight loss. Treatment is still available at this stage of the infection, although it may be more involved than earlier.
If left untreated, syphilis can go on to cause serious damage to the body’s internal organs including the brain, nerves, eyes, heart, liver, bones and joints. The damage may be serious enough to cause death. (For literature and music buffs, Karen Blixen and Mozart both died of complications related to tertiary syphilis). At this stage, syphilis becomes difficult or impossible to treat and the damage to organs is irreversible. How do you make sure you do not get to this stage of syphilis? Test regularly (at least once a year) so that you can be treated and cured if infected.
The only way to know for sure if you have syphilis is to get a blood test. Syphilis has a window period, so if you are at high risk (for example you have had sexual contact with someone who has syphilis or had many multiple casual partners) you will probably need more than one test over a period of three months.
For most sexually active men, a yearly, half yearly or quarterly testing – depending on your number of sexual partners – is advisable. Tests for syphilis and other STIs are available at Sexual Health Clinics at Royal Perth Hospital and Fremantle Hospital, FPWA, the WA AIDS Council, GPs, and at the Sauna Sexual Health Clinics at Perth Steamworks and Beaufort 565. Call the Western Australian AIDS Council on 9482 0000 for more information.
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Ben Bradstreet – Sauna Outreach & Community Development Officer / Community Education & Prevention Services / WA AIDS Council
