Living with HIV

Syphilis

Syphilis is a sexually transmitted infection that can have very serious complications when left untreated. It can progress much faster in people living with HIV but it is simple to cure with the right treatment.

An increased HIV viral load (the amount of virus in your blood) means a greater risk to your health and also makes contracting syphilis more likely if you are having regular sex with multiple partners or you suspect your partner is having sex outside your relationship. Syphilis can also increase the HIV viral load in semen, pre-cum, vaginal fluid and anal mucus because the immune system is fighting both HIV and syphilis.

Syphilis is transmitted through:

  • any sexual practice where there is skin-to-skin contact (most commonly in practices in the lead up to sex);
  • oral sex;
  • vaginal sex;
  • front hole sex (trans men); and
  • anal sex.

Symptoms can often be mild or you can be asymptomatic, which means you can pass on the infection without knowing you have it.

Testing

There is currently a rise in syphilis rates in Victoria among men who have sex with men (MSM) with the majority of reinfections occurring among HIV-positive MSM. It is highly recommended that all people who are having casual sex or sex with multiple partners have a screening for syphilis every three months. Women should also be tested for syphilis if they are considering falling pregnant.

Screening/testing is done with a simple blood test that can be arranged by your regular GP or HIV doctor, or at a sexual health clinic or community health clinic. This testing can happen outside of regular HIV management and care. Depending on your location, results can usually be received within a week.

Treatment

If caught early, syphilis can be cured with antibiotics; usually a single dose of penicillin (alternative treatments are available to those allergic to penicillin) is extremely effective in treating the early stages of syphilis. Follow-up blood tests are recommended at one, three, six, 12 and 24 months after treatment. Is it also very important to notify all sex partners that they should get tested. You can notify partners anonymously through the Let Them Know website.

Progression of Syphilis if left untreated

Syphilis typically follows a progression of stages that can last for weeks, months, or even years. It can be harder to treat in its later stages but it is still treatable. This is why it is important to test and treat early. Possible symptoms that can appear if syphilis is left untreated are:

  • Flat, red skin rash on back, chest, hands and feet
  • Fever
  • Swelling of the glands in groin and armpits
  • Genital rash
  • Hair loss
  • Tiredness

If untreated symptoms may come and go for up to two years and may can cause serious problems with several organs including the brain and heart. For women, untreated syphilis can impact upon the viability of the fetus during pregnancy. In its later stages, syphilis is highly contagious in vaginal fluid, semen and blood.

Referrals

There are a number of clinics and practices across metropolitan and regional Victoria where you can have a safe and confidential conversation about getting tested for syphilis and other STIs. Visit the Better to Know website to find your closest centre.

Living Positive Victoria’s position on syphilis

Living Positive Victoria is strongly in favour of on-going, regular testing and recommends the continuation and expansion of public health campaigns to raise awareness of syphilis. Our position paper responds to the current Victorian syphilis among HIV-positive MSM.

Read more about our position on syphilis here:

LPV Syphilis Position Paper