ColumnsHealth & Wellness

AIDS Watch: Nothing to Clap About

Hard facts about syphilis and HIV.

Kelly McCann

By Kelly McCann

Let’s play a little word association game. I’ll say a word and you say the first thing that comes to mind.

Ready? Syphilis. What did you think of?

Maybe your first thought was Al Capone and his syphilis-related mental illness and death. Maybe you thought of the Tuskegee Experiment and all those black men who were unknowingly the subjects of a medical study gone horribly wrong. Or, maybe, you thought of the painless sore or “chancre” that is the telltale symptom of primary syphilis. All good answers, but my hope is that you will soon come to associate syphilis with HIV, especially if you are a gay man.

Syphilis is a sexually transmitted disease caused by light-colored, spirally shaped, worm-looking bacteria— Treponema pallidum —which is Greek and Latin for pale, twisted thread. The bacteria wiggle vigorously when viewed under a microscope. It’s mildly disturbing to think about such wriggling going on inside one’s body. But I digress….

Syphilis is transmitted during vaginal, anal, or oral sex when the chancre or syphilis sore of the infected person comes in direct contact with the mucous membrane of the sexual partner.      

About three weeks following infection, symptoms occur. The primary stage of syphilis is characterized by one or more small, round, and painless sores that appear where syphilis entered the body. These chancres last about three to six weeks, and then disappear without treatment.

However, that doesn’t mean syphilis has completely gone away. Rather, it then progresses to the secondary stage.

Symptoms of secondary syphilis may appear a few weeks after the chancre heals and include a faint, reddish-brown rash on the palms of the hands and the soles of the feet. Other possible symptoms of secondary syphilis are patchy hair loss, sore throat, fever, and swollen lymph glands. The symptoms of secondary syphilis resolve with or without treatment, but without treatment, the infection progresses to the latent and late stages of the disease.  

Late stage or tertiary syphilis can be present without symptoms for many years, but the infection is still there working to damage internal organs, such as the brain and nervous system, eyes, and heart. As a result, late-stage syphilis can cause dementia, blindness, and even death.

Since syphilis is such a serious condition, it is important to know if you are infected. Syphilis can be diagnosed by examining material from the chancre under the microscope, so if you have a painless sore, get to the doctor before it goes away. Syphilis can also be diagnosed by a safe and inexpensive blood test which can be administered by your private physician or health care staff at numerous community health providers in our area.

If you discover you’ve got syphilis, don’t despair. It is easy to cure in the early stages. Since it is caused by a bacterial organism, antibiotics can eradicate the infection. For persons infected less than one year, a single shot of penicillin will do the trick. For longer-term infections, additional doses may be required. But the bottom line is this: Effective treatment for syphilis is available.

Now for the bad news. Just seven short years ago, the number of syphilis infections in the United States dropped to the lowest level on record. However, since that time, syphilis rates have risen sharply in our country. What is especially disturbing is that the majority of the new cases are occurring in gay and bisexual men.    

Get this: Gay and bisexual men accounted for seven percent of the syphilis cases in 2000, but more than 60 percent just five years later!

Our own city’s Department of Health and Human Services reports that Houston currently ranks second in the nation for the greatest number of primary and secondary syphilis cases. Men who have sex with men have accounted for 45 percent of primary and secondary syphilis cases diagnosed in Houston between January and May 2007.

Please be careful, my brothers. Having syphilis could set you up for other serious infections, like HIV.  

It’s a fact. Researchers have found that persons infected with syphilis have an increased chance of contracting HIV. According to the Centers for Disease Control and Prevention, syphilis increases one’s chance of contracting HIV by an estimated two to five times!  

That’s because the sores or chancres caused by syphilis make it easier for HIV to enter the body. On the other hand, if you already have HIV and then become infected with syphilis, the chancre also makes it more likely you will transmit HIV to your partner. Such double-trouble was eloquently summarized by Dr. Khalil Ghanem of Johns Hopkins University School of Medicine when he stated, “Syphilis and HIV have a close, deadly symbiotic relationship.”

So what can a gay man about town do to avoid such symbiosis? For starters, leave the lights on! Seriously, get a look at your partner’s parts. If you see a sore on the genitals, anus, or mouth, you might tell him you’ve developed a headache and politely excuse yourself.  

Visible chancre or not, if you decide to engage in sexual activity with another person, you should always utilize barrier methods, such as condoms and dental dams. They will help prevent syphilis, HIV, and a whole host of other sexually transmitted infections.  

To learn more about syphilis and its relationship to HIV, visit .

Kelly McCann is the chief executive officer of AIDS Foundation Houston. Details:


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