Love Safely: Understanding Syphilis in LGBTQ+ Relationships

What is Syphilis?

Syphilis is a common sexually transmitted infection that is curable and is caused by the bacteria Treponema pallidum. It progresses through four stages (primary, secondary, latent, and tertiary stages) with different symptoms and the progress of these stages can take weeks/months/ even years. 

How do I know?

In many cases, syphilis infection may get unnoticed initially as it may not lead to any symptoms, or they are not recognized, or the symptoms disappear. However, the bacteria will remain in the body and, after some time, can cause serious health problems. In the primary stage (usually after 2-3 weeks after sexual exposure), the person might get a single painless ulcer (chancre) or sometimes multiple such ulcers in genital/anal region which may last for 3-6 weeks and disappear even without treatment. In the secondary stage, one might get skin rashes, rashes in palms, sores in mucous membranes like mouth, vagina, anus etc. Some might even notice fever, swollen lymph nodes, sore throat. All of these symptoms too go away with or without treatment. Latent stage is when there are no symptoms but there is infection and can still be transmitted to partners. This can go on for years. Tertiary stage occurs rarely among those who are untreated and can lead to complications in multiple organs like brain, heart, eyes etc. Syphilis is detected through reliable screening tests such as VDRL, TPHA tests and other confirmatory tests. 

How do we get infected? And how do I protect myself?

Transmission usually takes place through direct contact with a skin ulcer caused by syphilis. Contact can occur during all kinds of sex practices. This can even occur during kissing or oral sex, when an ulcer has formed in your partner’s mouth. The use of condoms can thus only partially reduce the risk of infection. Hence regular testing for yourself and your partner (once in 3-6 months based on how active sex life is) is an effective strategy along with condom use to detect infection early and prevent further progression/ transmission.

How is it treated? 

Syphilis can be treated and cured easily with antibiotics. In its primary, secondary and latent stages, syphilis is treatable with antibiotics and the duration of antibiotics depends on which stage your infection is in. Remember that it is extremely important to check the response of treatment by taking a follow-up blood test (VDRL/RPR tire) after three, six, 12 months of having taken the medication based on the initial titers.

Check out more content on STIs like Gonorrhea, Chlamydia, Hepatitis A/B, Hepatitis C, Herpes, HPV, Genital Warts, Crabs, Scabies, Fungi.

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About the Author: Raju Behara (she/they), a trans-disabled Peer Support Provider with a decade of healthcare experience, holds a Masters in Pharmacology and a PG Diploma in Health Economics, Health Policy at the Indian Institute of Public Health. Aligned with the Safe Access Community Wellbeing Project, Raju has contributed to LGBTQIA+ safety in Indian workplaces, drafting gender-neutral dress codes and working on sensitization. A published author and poet in various anthologies, Raju, through EQUAL fellowship, chronicled social histories of housing, healthcare and workplace discrimination for queer-trans individuals in India. They initiated ‘Queer & Quarantine’, a crisis intervention program for trans folks facing housing challenges.

Article Vetted by: Dr. Swathi SB


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