Syphilis is a Sexually Transmitted Infection (STI) that is usually passed on during oral sex, anal sex, skin-to-skin contact or when sharing sex toys. 

Once seen as a relatively rare infection in Australia, in 2020, syphilis infections increased by nearly 90% from recorded rates in 2015.

Syphilis can be cured through a simple course of penicillin injections. But to get treated, you first have to get tested. In this article, we take a look at how syphilis testing works, how early you should get tested, and answer all those other burning questions about testing for syphilis. 

HOW DO I KNOW IF I NEED A SYPHILIS TEST?

If you are sexually active you should be getting tested for syphilis, HIV and other STIs once every three months. If your partner tells you they’ve tested positive for syphilis, you should also get tested and speak to your doctor about treatment. Syphilis can sometimes be asymptomatic, which means there are no symptoms at all, so you never need to wait for symptoms to test! 

Symptoms of syphilis appear in stages: primary, secondary and latent. If you do get them, symptoms of syphilis can include: 

• A visible sore, also called a “chancre” (the primary stage)
• Rashes (the secondary stage)
• Flu-like symptoms (the secondary stage)

Getting tested is quick and easy, and if you do test positive, syphilis can be treated (and cured) with penicillin injections – usually two, but the exact number depends on how far your infection has progressed.

You want to get treated to prevent progressing to the latent stage where serious health issues can occur such as complications with your heart, brain, nerves and bones.

HOW TO TEST FOR SYPHILIS IN MEN

Syphilis is usually tested via a blood test, where a health professional will take a small sample of blood (often from a vein in the arm) for analysis in a lab. Syphilis can also be tested by swabbing any visible ulcers/sores. Whatever testing method your health professional recommends, it’s quick and easy and will be done in a few minutes. 

HOW EARLY CAN YOU TEST FOR SYPHILIS?

To put it simply, it’s never too early to go and get a syphilis test. If you are showing any syphilis symptoms, book in for a test ASAP. Regular testing, once every three months, is the best way to identify if you have contracted any STI, syphilis included. 

You might have heard of something called the ‘window period’. This is the time it takes between being exposed to an infection, and it showing up in a test. The length of a window period varies based on the type of STI, what type of test you have, immune response, and other factors.

According to Dr Vincent Cornelisse, Sexual Health Physician at the Melbourne Sexual Health Centre (MSHC), who is also completing a PhD on the prevention of STIs, the window period for syphilis is six weeks. A syphilis test taken after this period can be considered conclusive, if you haven’t been exposed to infection in the meantime.

MY PARTNER TESTED POSITIVE FOR SYPHILIS BUT I DIDN’T

There are various reasons why your partner may have tested positive for syphilis but you didn’t. But the most common reason is you may have tested too soon after exposure for the infection to show up in a blood test. Your doctor/GP can advise if you need a follow-up test.

DOES SYPHILIS SHOW UP IN NORMAL BLOOD TESTS?

A standard blood test, where a small sample of blood is taken from a vein in your arm, can be used to screen for syphilis.

However, if you’re getting a blood test for something else, the pathology may not test for syphilis. You need to specifically ask your doctor to test for it so the pathologists know what to look for. Most sexual health screens for guys who have sex with other guys will include a blood test for syphilis, though when in doubt make sure to ask.

WHAT HAPPENS IF I TEST POSITIVE FOR SYPHILIS?

If you test positive for syphilis, step one is not to worry. You did the right thing and got tested, and now your doctor can get you treated. Here is what you can expect:

• Your doctor will prescribe you a series of penicillin injections to clear the infection. Depending on how far your infection has developed, treatment could last up to three weeks 
• Your doctor may advise that you avoid sexual contact for a week or so after your treatment has finished. That way you’re helping to keep others safe too, whilst the infection clears 
• You might also be advised not to have sexual contact with partners from the past 12 months until they also have been tested and treated. This will help stop the chance of re-infection
• You’ll need to let your sexual partners know that you’ve tested positive for syphilis, so they can get tested and treated too

PREVENTING SYPHILIS

Using condoms for oral and anal sex and gloves for arse play is a safe way to reduce the risk of not just syphilis, but other STIs as well. Remember that only areas covered by a condom or glove are protected from infection. And if you’re on PrEP, keep in mind that PrEP only protects you from HIV, and not other STIs like syphilis, chlamydia, gonorrhoea etc.