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Straight Talk About Syphilis

February 2001

We're HIV-positive, we live in Los Angeles (L.A.) County, and we value our health. We work hard for it. We're more aware than most. We've seen the billboards and print ads. We've heard the radio spots. We know the basics of HIV transmission, and we're well aware of last year's syphilis outbreak.

With more than half of the 144 cases of syphilis detected in L.A. County last year occurring in individuals who were already HIV-positive, the word is out: HIV and syphilis infection are closely related.

Message broadcast; message received: so far so good. What we need now is some more discussion about why people like us need to get early treatment and/or to avoid syphilis co-infection entirely.

Our Plates Are Full

Those of us who are HIV-positive already have plenty of health concerns. Let's face it: With issues like treatment options, adherence, side effects and opportunistic infections to consider, our plates are full.

We also have very real needs. Sharing and expressing intimacy and passion are important. After all, we're still human beings. With these health concerns and natural desires on our minds, thinking about one more issue can be difficult. Still, syphilis is a subject well worth taking a bit of time to learn about.

As survivors, we've had to renew our resolve before. Now more than ever we need to understand and protect ourselves against anything that could complicate our condition and challenge the level of health we work so hard to maintain.

Fortunately, we can learn enough to protect ourselves and our partners with some basic knowledge. Let's review a few of the important points about syphilis, and then talk about what each of us can do.

Key Points

There are a few important things we need to understand about syphilis, other than the basic signs and symptoms (which you can review, along with the other major STDs, in this month's "Everything You Always Wanted To Know About STDs").

  • The same kinds of unprotected sex that put us at risk for HIV also put us at risk for syphilis. This includes unprotected oral, anal and vaginal sex.

  • Early detection can be difficult, but if you know what signs and symptoms to look for in you and your partners, you have a better chance of avoiding transmission and getting early treatment.

  • Early treatment is important. If syphilis goes undetected for too long, it can cause irreversible damage.

  • As with HIV, you can't know for sure if you or your partners have syphilis until you get tested.

  • First-stage syphilis sores increase the risk of HIV infection and re-infection, creating a sort of open door that HIV can enter.

  • If you're HIV-positive and you contract syphilis, treatment may be more challenging. Like many other infections that we may get in addition to HIV, syphilis can complicate things.

  • Syphilis is treatable and curable. Ultimately it is a bacteria, and can be treated and cured with antibiotics, even if you're HIV-positive. So don't hesitate to get tested!

  • There are some great strategies you can take to protect yourself from this disease, as well as many local resources to help inform and empower you.

Health Comes First

If you've come this far, you're probably concerned about you and your partners' health, and you realize what a threat syphilis infection can be.

Now we need to think about how we can make sure that we people with AIDS remain free of syphilis co-infection. From a practical standpoint, forcing our partners through a thorough visual inspection, cavity search, and disclosure of medical records and lab results are probably not the most constructive approaches to syphilis prevention (and sure to ruin the vibe on a first date!).

Neither is closing our eyes and hoping for the best. We need to become familiar with other strategies. It's time to take matters into our own hands.

Here are some tips and resources we can use for avoiding and/or coping with co-infection with syphilis, as well as other STDs:

  • Those of us who are sexually active should get tested for Syphilis every four to six months. We should also be screened for other STDs.

  • Although sores can occur in places a condom doesn't cover, we need to use condoms as often as possible. Condoms provide at least some level of protection from syphilis.

  • We can't afford to ignore possible early signs and symptoms such as an isolated painless open sore appearing on the lips, penis or vagina that may emit fluid, or an overall body rash that also appears on the palms of the hands and soles of the feet. If these occur, an immediate examination is in order (see list of STD testing and treatment sites or call the national STD and AIDS hotline: 800-CDC-INFO for a testing site near you).

  • We need to be on the lookout for these signs and symptoms in our partners as well.

  • We need to work toward delaying sex with new partners until we've had time to ask them key questions and get a good indication of their sexual and testing history. It's intimidating at first, but with practice it can be done.

  • When possible, we can ask a potential sex partner about their STD testing history outright. A confused or guarded answer may give us the cue to insist on protection or pass on the encounter entirely.

  • We can try a similar strategy with people we meet on the Internet, before we meet them in person.

  • We can work toward limiting the number of people we have sexual contact with.

  • If we visit a bathhouse or sex club, we can go to one that has well-lit areas, and that doesn't mind handing out free condoms and lube, and use them as often as possible.

  • We can break convention and initiate conversation with bathhouse and sex club partners.

  • We need to know the risks of mixing substances and sex, especially with first-time partners or in sex clubs and bathhouses. When we do, our judgment becomes cloudy in direct proportion to the rise in our libido.

  • We can try to make day-to-day and moment-to-moment sexual choices that are as good for us as the advice we give to those we care about. How many of us treat ourselves with the care and respect we extend to our best friends?

  • If we feel we may already have put ourselves at risk for syphilis co-infection, we need to get checked out right away. Then, regardless of the outcome, we should forgive ourselves (we're only human) and begin protecting our partners and ourselves as soon as possible.

  • We can check out AIDS Project Los Angeles' upcoming wellness program. Information will be available at soon or call Buddy Akin at (323) 993-1515.

    Buddy Akin is a health promotion specialist at AIDS Project Los Angeles. He can be reached by e-mail at

    This article has been reprinted at The Body with the permission of AIDS Project Los Angeles (APLA).

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This article was provided by AIDS Project Los Angeles. It is a part of the publication Positive Living.
See Also
Syphilis -- a Dreadful Disease on the Move
Syphilis Fact Sheet
Basic Questions and Answers About Syphilis and Men Who Have Sex With Men (MSM)
More News and Research on Syphilis in the U.S. and Canada