by Dr. Joanne Stekler - Special to the SGN

Joanne Stekler, M.D., MPH, is Deputy Director of Community Services for the HIV/STD Program at Public Health - Seattle & King County. She is also an internal medicine and infectious disease physician at Harborview Medical Center, and assistant professor of medicine and epidemiology at the University of Washington.

This is the fifth in a series of articles focusing on HIV and other STD prevention and care topics for Gay/Bisexual men and Transgender individuals in Seattle and King County.


Why am I talking about syphilis again? Because, like it says in our ad in this week's SGN, 'Your penis isn't the only thing that's on the rise.'

In 2010, there were 289 cases of syphilis in King County. That's the highest number of syphilis cases in decades, and it isn't slowing down. In the first three months of 2011, we've seen nearly twice the number of cases compared to the same time last year. It's mostly in Gay and Bi men, and over half are guys who are HIV-positive.

In response to this, Public Health is launching an education campaign to call attention to what's going on, help guys recognize the signs and symptoms of syphilis, and promote testing and treatment. Gay City, Lifelong AIDS Alliance, and other community organizations in Seattle are also working to get the word out.

In case you didn't know, syphilis is a bacteria that causes several stages of disease. At first, you get a painless sore. The sore could be in your mouth, on your penis, or on your butt. The sore will go away on its own, but the syphilis won't. After a few weeks or months, you could get a rash on the palms of your hands, on the soles of your feet, or on other parts of your body. This also could go away on its own. But if syphilis still isn't treated, it can cause more problems. You could become blind or deaf. In the last stage, people can have brain, nerve, or heart problems.

People have even died from syphilis - people like Al Capone, Tolstoy, and Scott Joplin, to name a few. If you have HIV, syphilis may progress more quickly through these stages. The good news is that there's an easy blood test for syphilis, and antibiotics make it easy to cure.

This sounds simple. So why doesn't everyone get treated when they have symptoms?

Well, both the sore and the rash go away on their own. When things get better, we stop thinking about them, right? Also, syphilis can be hard to recognize because the symptoms aren't specific. That means other diseases can cause the same symptoms. Until we do some tests, sometimes it's hard for doctors to know whether the symptoms are caused by syphilis or by herpes or by primary HIV infection or by something else. (Check out ru2hot.org if you want to learn more about the symptoms that happen in the first few weeks after someone gets infected with HIV.)

Finally, it's sometimes surprising to learn that we're at risk for an STD when we think we're doing everything right. For example, some Gay and Bi guys have only oral sex to decrease their chances of getting HIV and other STDs. But syphilis is spread easily through oral sex.

So if you have any of the symptoms - especially an open painless sore or a spotted rash - get tested for syphilis. Today.

Even with no symptoms, sexually active Gay and Bi men should get tested for STDs at least once a year. You should get tested every three months if you use meth or poppers, if you had unprotected anal sex in the last year with a partner who was a different HIV status than you, if you had more than 10 sex partners (for any kind of sex) in the last year, or if you've had Chlamydia, gonorrhea, or syphilis recently.

What else can you do to help stop this syphilis epidemic? Talk to your friends and partners about syphilis and other STDs. If you blog, tweet, or use Facebook, post about syphilis. Check out the campaign website at www.SyphilisRising.com. Check your own body for sores and rashes. Make looking for sores and rashes on your partners part of foreplay. And if you find something, don't have sex until you (or they) get tested and treated.

Syphilis. Easy to get, easy to cure.

If you're a guy who has sex with other guys, you can get tested for syphilis and HIV at Public Health's STD Clinic, at Gay City, or at your doctor's office. For hours and locations, call 206-296-4649 or go to www.kingcounty.gov/health/std.

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