Our sexual health services across the country have changed how they deliver healthcare since COVID began. During this time, I’ve worked as a Sexual Health Advisor for an integrated sexual health service in East London and noticed a recent increase in patients testing positive for syphilis during pregnancy. Oftentimes, patients test positive via antenatal clinics and end up being referred to our service for treatment.

I am also seeing that a lot of women that don’t know that if you get syphilis during pregnancy, the infection can cause serious problems including miscarriage or stillbirth. If syphilis remains untreated during pregnancy, then babies can be born with congenital syphilis – a severe and often life-threatening infection in infants.

For some of the women, this test happens to be the first and only STI test they've ever had, so naturally, the result can come as a shock. For other women who have had sexual health screens in the past and have received negative syphilis result, a positive diagnosis can also come as a surprise, too.
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However, whatever the situation, my job is always to provide the patients I see with information. I explain the routes of transmission and symptoms. I encourage and support them to inform their recent sexual partners to get tested and treated. I suggest treatment and explain their responsibilities for future STI testing to protect themselves and their partners.
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It’s important that people know that free syphilis screening is available on the NHS to anyone who is pregnant. Treatment can then be offered to anyone who is pregnant who has syphilis.
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Want to know your sexual health status? Do a full sexual health screening NOW!

When Billie got a call from a friend he'd had a threeway with, he was advised to go and get treated for syphilis.

A few weeks after I had a threeway with a friend, Carlos, and his partner, he called me to say he thought he had syphilis. He'd been for his regular HIV appointment and had asked the doctor to look at a sore on his penis.

The doctor said she was pretty sure it was syphilis, and took tests and started him on treatment straight away. When Carlos called me from the clinic to tell me, he said the doctor advised me to come in to be tested, just to be sure.

Carlos mentioned that the treatment he'd just had was uncomfortable - but I wasn't ready for what waited for me at the clinic! The doctor took a blood test, and then advised me to get treated anyway, before waiting for the test results to come back in.

Because I was going away for work later that month I decided to have the treatment. The nurse asked me to take my trousers down and get on the couch. The poor nurse! I've never sworn so much during a medical appointment! Just as I got off the couch and started buttoning up my jeans, the nurse told me to get back on the couch, because there was another injection to do.

I'm not going to pretend that it was a pleasant experience but it wouldn't stop me getting tested or treated again. I've been treated once since, and it was nowhere near as painful the second time round.

A week later I got a call to say that the syphilis test had come back negative. I don't regret being treated – I know if I'd waited and syphilis had developed, the treatment would have involved more injections.

I'm also glad that Carlos told me: he could've waited to see if his results came back positive for syphilis. But he trusted me to make my own decisions with my health.

I’ve had syphilis a couple of times. The very first time I had it I found out through a routine test, as I didn’t have any symptoms. I was relatively aware of sexual health and the symptoms of STIs. I was already diagnosed with HIV, so it wasn’t a huge thing for me.

I saw it as something that affected people in olden times. My only association with it was that it killed monarchs. I felt like it didn’t come up as much as other STIs, I felt like HIV was always at the forefront of sexual health for queer men, but syphilis wasn’t talked about as much.

I previously had a negative experience at a sexual health screening years ago where a nurse made me feel really alienated; she didn’t recognise my symptoms and I was being blamed for the return of gonorrhoea in the UK because I said I didn’t know where it came from. I think she was homophobic, seeing my sex life as a cultural issue. I was only sleeping with one person at the time. I was treated even though they didn’t test me which is different now because there are fears of antibiotic resistance.

I had an issue where I couldn’t hear properly, like someone had their hand over my ear. I went to my GP who rinsed it out. No change. Nothing. Around the same time, I had an HIV appointment. I came into contact with syphilis and I told the HIV doctor that I also had impaired hearing in one ear. She looked at me, concerned, and said “syphilis can cause deafness”. My world collapsed. Turns out, after she spoke to a colleague and I went back to the GP, that deafness was a symptom of very advanced but what I actually had was very advanced ear wax.

I don’t know why syphilis gets such a bad rep; people don’t really talk about it much. It was treated and it cleared up very quickly.

In Phil’s Syphilis Story, he discusses the first time he had syphilis, and the difficulty in disclosing his diagnosis to his partners.

‍I last had syphilis about three years ago when I had developed a rash on my upper body that just wouldn’t go away. I visited my GP thinking it was something like a skin problem. After examining me for a while, she suggested that I go and have an STI test as it might be syphilis. I thought she must have been mistaken as I had not experienced the common earlier symptom of a sore on my genitals (called a chancre sore) but I booked in for a test at 56 Dean St in London right away.

When I got to the clinic, they looked at my rash, did some weird reflex tests and they were pretty certain that it was syphilis. They treated me for it while I was there. The treatment was a rather large injection into my bum cheek which left it numb for quite some time.

This was the first time I’d had syphilis and I didn’t really know too much about it, as it felt like it was something you only heard about in some BBC period drama. That was a similar reaction when I told those I needed to about it too. Because of this I admit I felt quite uncomfortable with it, it seemed to have a bit more stigma than other more commonly spoken about STIs. I think this has a lot to do with how it can develop when it gets to the later stages of the disease.

While at the clinic they gave me a leaflet about a text service to tell my partners but I thought I would be fine telling them myself. This was at a bit of a chaotic time of my life which involved regular group sex. I wasn't really able to narrow it down enough to one or two people, so I had to message a handful of people. The task of this dawned on me when I messaged the first guy and he immediately denied that he would have it and that I shouldn't message him again. Crikey! I messaged the others and it was a mixed reaction, some acting as if they were too pure to get an STI but the others more understanding. I guess I had expected everyone to be understanding, especially as there was a good chance I could have got it from any one of them. The bad reactions just added to my own anxiety around having it and because of this, I didn't really discuss it with my friends through that same fear.

In Leander’s Syphilis Story, he discusses his recent experience of syphilis, and why he thinks it needs to be destigmatised.
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My first experience of syphilis happened only a month ago. I noticed I had a light rash on my chest, stomach and upper legs. It wasn’t uncomfortable or itchy, it was just very visible and it didn’t look great. I’m a porn actor, so having a visible rash isn’t very good in my profession, so I decided to go and get tested right away.

I went to 56 Dean St in London and the doctor there immediately recognised it and gave me treatment before waiting for the test results. As ever, they were extremely friendly, knowledgeable, helpful, and put me at ease. The treatment was an injection in the butt cheeks, which was quick and easy. That evening I had fever and chills, as the medication fights the syphilis it can be uncomfortable, but not painful. Although they treated me straight away, I got the test results back within 24 hours and it confirmed that I had syphilis.

I’d obviously got syphilis through fucking, which in my job happens fairly frequently. I’m not sure where it originated from as a number of people got it at roughly the same time. I told everyone I had been with about my diagnosis. They were all very grown up, thanked me and went to get tested as soon as possible.

Although it was my first time having syphilis, I knew all about it. It pays to inform yourself about sexual health in my industry. I know first hand that knowledge of syphilis isn’t that widespread and that stigma exists. There are definitely a lot of people out there who think it disappeared in the 19th century. It did not. Syphilis has had “bad press” for centuries, it reminds us of a time before antibiotics when STIs invariably led to visible, unpleasant and unattractive symptoms. Now we have the meds, and the means to test for it quickly and easily, but a bad reputation is hard to shake. Hopefully people sharing their stories like this will help to change that.

When it comes to something like syphilis where people may not be as informed about it, it leads to fear, which in turn leads to stigma. All STIs are stigmatised to some degree, which is ridiculous. Getting an STI is not any more shameful or sinful than catching a cold or getting a sunburn - but ignoring them and not getting tested is irresponsible and unkind to everyone else out there who’s doing their best to contain the spread.

In Marc’s syphilis story he discusses living with HIV, having syphilis and sex without condoms and what he does to avoid getting and passing syphilis onto his partners.
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I’m a gay man who’s been living with HIV for over 30 years. I never wanted to pass on HIV to anyone else, so using condoms during sex for most of my diagnosis was a no-brainer. I’m not claiming to be a ‘good HIV+ person’ by doing this. I’m gonna be honest - I never liked using them. Condoms were a necessary evil. Not only were they uncomfortable and ugly, the physical barrier they offered became a psychological barrier to intimacy and connection. Condoms as effective as they are, were always a reminder of the scary beast that was in the community was right here in the bedroom.
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Sero-sorting (having sex with people with the same HIV status) happened occasionally, which meant condoms went out the window (or stayed in the condom pack). But generally, condom use was consistent. I’m from the generation that was taught ‘Safer Sex’ (condom use) = ‘Hot Sex’ and ‘barebacking’ (condomless sex) = taboo/death.
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As a HIV+ man I was always aware of STIs, but always in the context that they might make HIV transmission to the people I was having sex with easier. Apart from a case of gonorrhoea in the 80s, I hadn’t had a single STI in over 20 years. So as annoying as those pesky condoms were, they prevented me passing HIV on to my partners AND they stopped me getting any STIs.
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In 2009 after a break-up, I used my newfound freedom and hitting my 40s to reconnect with my sex life and get back out there. Something had shifted in me and the world and condoms seemed…. well, past their sell by date. On the hook-up apps I joined I was met with requests for bareback and raw sex. After almost 30 years of hyper-vigilance and near consistent condom use, this brave new condomless world was both a revelation and liberating. Coupled with the emerging news that people with HIV who were on treatment couldn’t pass HIV on to their sexual partners, and armed with just a bottle of lube and my phone, I embarked on my ‘condom-free’ journey of discovery.  
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But it wasn’t too long before I felt a constant pain in my joints. A red rash appeared across my chest and I started to get a high temperature. I also experienced night sweats (sweating profusely during your sleep), which was particularly frightening as night sweats were a symptom of my HIV infection I hadn’t experienced since starting HIV treatment in 2001. I popped along to my GP, who couldn’t work it out.
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I felt like shit! I was worried and perplexed and didn’t have a clue what to do. About a week after that appointment, a sore appeared on my genitals. That’s when I knew I needed to speak to my HIV clinician. The sexual health clinic I attend for my HIV care diagnosed syphilis straight away. I received my treatment (pretty simple - a couple of shots in the buttocks) and was sent on my way.
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Within a few days the pain in my joints eased up, the night sweats stopped, and the red rash cleared up. I’d like to say ‘lesson learnt’ but I’ve since had syphilis twice. I feel no shame in that. It comes with the territory of being a HIV-positive man that has a happy and healthy sex life (although I could always do with more!).

However, I haven’t completely thrown caution to the wind. I later found out that the symptoms I’d experienced were more severe because of my HIV. And as simple as the treatment of syphilis is, I don’t want numb bum cheeks too often.
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So, I do a few things to make sure my partners and I can reduce the risk of passing on or getting syphilis. I test for syphilis at every HIV check-up, which is usually every 3-6 months. And because I’ve had syphilis in the past, some syphilis tests will give a positive result, so it’s really important I let the nurse and doctors know I’ve had an infection before. We don’t want to have to start treatment again.
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I’ve been HIV undetectable for over 18 years so I’m not going to pass on HIV and I’m very open about my HIV status. This allows me to have conversations with my sexual partners about syphilis and negotiate the kind of sex we’re going to have AND if we’ll use condoms.
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My diagnosis with syphilis came as a surprise.  Because I have sexual health check-ups at least every 6 months, I know almost exactly when I got syphilis. It was during a visit to Madrid. A few months after the trip, during a routine STI check up I finally found out what was wrong with my finger. After weeks of having an infection on the tip of one of my fingers, and having it checked out by a number of doctors, I found out that the infection was a syphilis symptom.

None of the doctors I visited recognized it as a syphilis symptom – and I’d even had minor surgery to try to clean the infection from my finger. But it was the sexual health clinic visit that finally solved the puzzle. A few weeks after the Madrid sex party I remember having a minor rash on my body. But it wasn’t significant enough to cause me any concerns. But looking back, that might have been another syphilis symptom.

The thing is that none of the men I had had sex with had any symptoms themselves, or any that I could see. It’s probable that I got syphilis on my finger from touching a guy’s penis or playing with his ass. If it was from the ass-play then I wouldn’t have been able to see any of his symptoms, even if he had any.

What this taught me was that it’s possible to get syphilis from sex that we think of as being ‘safe’. I didn’t get syphilis by having sex without condoms – I got it from fingering.

When I found out I had syphilis I wanted to make sure everyone I’d been in sexual contact with knew that they could have it too.  Because I’m pretty sure I got it during a hook-up on that visit, I tried to contact as many people as I could who I’d had sex with. I asked those guys to also let the other guys they’d been in contact with know. I sent texts out – and asked them to spread the word.

But I was surprised by the response. There was a lot of resistance and some of my friends didn’t want to pass the information on. I think it comes from the stigma of having syphilis. When I’ve told sexual partners in the past about chlamydia or gonorrhea, the response has been different. But with syphilis, there is a different kind of stigma.

Maybe it’s something to do with perceptions of how easy it is to treat other STIs – take a short course of antibiotics and within a week, you’re treated and unable to pass those STIs on. But syphilis is seen as being more serious. Some of the guys I spoke to didn’t want to have sex with me soon after I was treated – maybe because they thought I was still infectious?

There’s still too much stigma about STIs – but we need to be able to talk about them, and to be honest about having had them.

I hadn’t visited an STI clinic for almost a year. Whilst I usually go every three months, I hadn’t been having much sex and was in between surgeries, so it didn’t feel necessary or important to stick to my usual routine.

Since starting the process of transitioning as trans, I started visiting places where I could be more sexually adventurous. And a few weeks after visiting a particular venue I started to get headaches and noticed a small rash on my stomach. I visited my GP who said it was a strep infection and, after a few weeks, the rash went away.

Looking back, I wonder if those were symptoms of syphilis? I’ve heard from other people that symptoms such as rashes are sometimes overlooked by GPs, especially when the symptoms aren’t severe.

After the surgery, I decided it was time to go and have a sexual health check-up and, at that appointment, I was diagnosed with syphilis. The clinic told me it was second stage or secondary syphilis, meaning that I had had syphilis for a few months, at least.

Because I mostly have sex with people I don’t know, or cannot be in touch with, I wasn’t able to let most of my sexual partners know that I’d had syphilis. The one person I could get in touch with had recently also been tested for syphilis, and had also tested positive.

I felt nervous having that conversation with them. What if they’d got syphilis from me? I mean I could’ve also got syphilis from them! But I didn’t know I had syphilis and I didn’t do anything wrong. And I’m glad I was able to be in touch with that person, and tell them that it was time for a check-up.

There’s not enough information around about syphilis and other STIs for trans people. It might be that, as with HIV, that trans people have greater susceptibility to syphilis. I know that starting to have sex in different networks of people means that my sexual practice, and possible exposure to syphilis has changed.

Getting diagnosed with syphilis didn’t surprise me. But it has reminded me of why it’s important for me to stick to regular STI testing. It’s also reminded me that I don’t need to be having lots of sex to be exposed to an STI.
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In Aaron’s Syphilis Story, he talks about how he had very prominent symptoms of syphilis which isn’t always the case.

I went to a chemsex party. I don’t go to them often, maybe once or twice a year. A couple of days afterwards, I had a pain in my groin, sores in my mouth and discharge in my penis.

Clearly, something was wrong so I ordered a self-test kit online. I sent it off and three or four days later my results came back saying I had syphilis, and it also said I had gonorrhea in my throat.

I let the guys at the party know straight away, and I told them to get tested. No one took it badly; they were actually very chilled about it and they were even thankful that I let them know.

I went to my local sexual health clinic for treatment. It’s easy, very accessible, and treatment doesn't really have any serious side effects. Syphilis is usually treated with penicillin injections but I absolutely hate injections because of having to have them done a lot as a child.

I was offered oral antibiotics instead. Normally it is given if you can't take penicillin for any reason such as having an allergy to it and I’m not sure a lot of people know you can do this. It’s good to have choices! The clinic called me back for an appointment to test me again and I tested negative this time. Sorted!

My doctor told me that in many cases syphilis doesn't show any symptoms. I believe it is important to get tested regularly: every 3-6 months depending how active your sex life is to deal with it before it gets serious.

In Mike’s Syphilis Story, he talks about how one of his major symptoms went completely unnoticed because having a very similar issue a few months before.

About 5 years ago, I had a really bad rash from head-to-toe for about two or three months from when my psoriasis flared up. So, when I got another rash, I thought it was the psoriasis again even though it looked completely different; it still covered me from head-to-toe, but it was a lot redder. On top of this, I had a fever, really bad aches and pains in my back, and in my knees too. It sucked because I was heading to Fire Island for a friend’s wedding.

Everything was so painful that I struggled to sleep. I couldn’t figure out what it was for the life of me. The fever was intense for only a day and the rash went away by itself after a month.I saw a different GP who misdiagnosed it and didn’t work out that it was syphilis. I think if I had seen my regular GP, she may have picked it up because I could have discussed the other symptoms I had.

I then thought that because I have psoriasis that I was getting arthritis as my feet had swollen up so badly. I had an appointment with an arthritis specialist, and the joint pain went away.

I went for a sexual health screening because I hadn’t tested for about 6 months, I have an open relationship with my husband, and he tested positive for gonorrhoea.

When I got my results back it turned out that I didn’t even have gonorrhoea, but I did have syphilis! It was a good thing that my husband got gonorrhoea because I didn’t notice the symptoms as a result of having it and I didn’t know how long it would have gone unchecked.

I looked up the symptoms and finally everything made sense! I got treatment and everything was fine. Now I get checked every 3 months just to be on the safe side.

In Antony's Syphilis Story, he talks about being very recently treated for syphilis. Being diagnosed came as a surprise to him because it wasn't long ago that he had tested negative for it. He didn't know the symptoms so he didn't know what to look out for.

I was treated for syphilis this week!

I get tested regularly and my last couple tests were negative for everything. I never had syphilis before and to be honest I never worried about it as I’ve had other STIs before.

My last negative test was in November. I got a text with some guy I hooked up with in September saying he slept with someone who tested positive for it. I asked him to let me know if he tests positive for it because there’s been times in the past where it turned out I didn’t have an STI and I didn’t want to build resistance to antibiotics. He didn’t reply.

So, I got a self-test, with the assumption that it was going to be negative because I was negative two months after we hooked up. My test results were quite delayed because there was an issue with COVID tests at the time. To my surprise, I tested positive for syphilis. 

I didn’t know the symptoms of syphilis; I had mild flu like symptoms – I felt really cold, shivery and I had night sweats. I even got a COVID test because I thought it was that. 

I still don’t know if it was him or from another guy; the window period is so big it might not show up straight away. I contacted casual sexual partners using contact tracing and I contacted the more recent ones directly, there were mixed reactions, one got treatment, another asked what it was, one was due a test and another blocked me. 

The clinic called me on Monday, I got treated on Tuesday and after a day and a half I felt so much better. 

In James' Syphilis Story, he talks about how he got syphilis on holiday not realising that his rash was a symptom. He went for a sexual health screening and later discovered that he had neurosyphilis!

I got syphilis in Berlin which is very on brand for me. I was there for a week and had just started Pure for Men, a natural fibre supplement. I developed a full body rash thinking it was a side effect from the capsules, so I stopped taking them. It wasn’t on my hands or face so I just assumed it would go away.

I went to Dean Street Clinic as I had a lot of condomless sex when I was away. They called me the next day, letting me know I had syphilis and that I needed treatment as the rash was getting really bad. It was the first time I ever got emotional about having an STI because it was so visible, but I was with my friend who said I would be fine. I contacted a couple guys that I hooked up with on Grindr to let them know.

Thankfully, I worked near the clinic, so I booked an appointment the next morning before I started work and got treated for it. I was single at the time and the biggest crush of my life was hitting me up, but I knew I had to be responsible.

I remember when I got to work, after receiving the treatment I was serving a customer who asked me if I was okay, I was confused, said I was and asked why they asked. The rash had now purged all over my face! It was so embarrassing. There was no way I was finishing my 12-hour shift, I had to leave work so I told my manager that I was having an allergic reaction to medication I was given and rushed back to the clinic.

They told me that I had neurosyphilis and the rash getting worse was actually a reaction to the treatment, but they said it should go within a few hours and they were right. Within 24 hours it was completely gone.

I was able to go to work the next day and now I can laugh about it and cross syphilis off STI bingo card.
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In Harvey’s Syphilis Story, he talks about how his intuition told him to get tested just in case as he had no symptoms at all.

About 5 or 6 years ago, I went to Dean Street Express for a sexual health check-up as something felt off. I usually test regularly but there was something that motivated this particular check-up.

I had a hook up with a random guy and he worried me a bit; I’m not entirely sure but I think he came to my house after hooking up with either someone else or a group of other guys.

My intuition was telling me that I should probably get tested just to be on the safe side. When I got my results back, I was surprised to learn that I had chlamydia AND syphilis at the same time! I had two STIs and zero symptoms.

I booked an appointment to go back for treatment which was completely fine, and I only had to tell one other guy who took the news well. He got tested and treated, and we hooked up again following that experience, once he had been tested and once I was fully treated and no longer infectious.

To be completely honest, I didn’t know much about syphilis until I was diagnosed with it. The only knowledge I had was from a film The Libertine set in the late 1600s where Johnny Depp’s character John Wilmot has it.

The most common symptom of an STI is no symptom whatsoever. I’m a prime example of this and this is why it is so important not only to test but to test regularly.

In Gerald Syphilis Story, he talks about how he didn’t notice the chancre sore on his finger as a symptom of syphilis, he thought it was a wart. 

I found out I had syphilis because a guy I had been dating tested positive.

I was seeing other guys but he wasn’t and was sure he got the infection from me. He had been more reluctant about condomless sex. I was on PrEP so for me it was normal, but he wasn’t and was a lot more cautious, so it seemed really unlucky.

We’d stopped seeing each other just before, basically because I was too uncommitted. It was nice of him to let me know he’d got syphilis, but that was the last time we were in contact, I think.

I didn’t get any obvious symptoms, but I did seem to get a chancre sore on my finger which I found really odd as I wasn’t sure what it was. I didn’t recognise it as a symptom. I thought it was a wart, but when I put treatment on it instead of getting better, it got worse. It went away after I got the syphilis treatment. The doctor told me that it was atypical to have a chancre on the hand, but that syphilis is a disease that does present in atypical ways frequently.

The treatment was an injection in each buttock and it was a bit more painful than the gonorrhoea treatment. I remember feeling bruised and sore for a couple of days but after that it passed and I was back to normal.

I got a phone call from a sexual health clinic on behalf of someone who was recently diagnosed with HIV; they said to get tested so I booked a half day at work.
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This was the very first time I went to a sexual health clinic back in 2007 in Wales and it was also the very first time I experienced having an STI, I was really nervous. The waiting room was a little strange because I was youngest guy there, as at the time there was a surge in STIs in men over 50.
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The waiting room was huge, and it felt bigger because there were only 10 people in there. I had to drink a couple glasses of water before I could give a urine sample.

I then had to wait to be called and the wait felt like ages! When I was finally called in, I had swabs and blood taken. I also got hepatitis A and B vaccinations.

Three weeks later, I got my results – I tested negative for HIV but positive for syphilis. I had no symptoms at all. I had to start treatment for syphilis, but they couldn’t give me the injection for penicillin, so they gave me tablets instead. I was vaccinated again, leaving with a letter saying that everything was fine. A lot has changed since then and I now get tested regularly.
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I was raised in the countryside in a village in Spain before moving to London. When I was 22 I went for a full physical examination which including testing for HIV and STIs. 6 months later, at 23 I got my first official boyfriend. The first time we had sex he took the condom off me without my consent. I should have told him to stop but I didn’t.

We continued having sex without condoms on different occasions. Not long after I noticed I had discharge coming out of my penis. I had a sore on the head of my penis and it was very itchy. The whole thing was very traumatic because I had no idea what was happening. I went to the sexual health clinic and I was told that I had syphilis, gonorrhea, and chlamydia all at once.

I was really shocked as the only reason I even agreed to not use condoms was because I thought we were being monogamous with each other. I was very naïve at the time and I was very trusting, maybe too trusting. I had absolutely no knowledge about sexual health or STIs at the time, so I thought I was going to die!
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I got treatment over three consecutive weeks. My ex was 27 at the time. He had never ever tested for HIV or STIs before and I learned a very valuable lesson from this experience. It’s so important to talk to your long term partners about their sexual history. It’s up to you to take care of your sexual health and the responsibility should never be in anyone else’s hands.