Syphilis is a bacterial infection caused by the spirochete bacterium Treponema pallidum that is primarily transmitted through sexual contact. This infection progresses through distinct stages if left untreated, potentially leading to severe health complications affecting the heart, brain, and nervous system. Understanding the steps for prevention is paramount to protecting personal health and the health of partners. This overview focuses on strategies individuals can employ to minimize their risk of acquiring or transmitting this sexually transmitted infection.
Understanding How Syphilis Spreads
Syphilis is transmitted during sexual activity through direct contact with a syphilitic sore, known as a chancre. The bacteria pass from the infectious lesion of one person into the body of a partner, often through tiny breaks in the skin or mucosal membranes. Chancres are the manifestation of primary syphilis, presenting as firm, painless ulcers that develop at the site where the bacteria entered the body.
These sores are highly infectious and commonly appear on or around the genitals, anus, rectum, lips, or in the mouth. Because the chancre is often painless and can be hidden, an infected person may not realize they have the sore or that they are able to transmit the infection. Transmission can occur through vaginal, anal, or oral sex, as these activities facilitate contact with the infectious lesion. The bacterium T. pallidum is fragile and cannot survive long outside the human body, meaning transmission almost exclusively requires direct, intimate contact.
Essential Strategies for Prevention
Prevention involves a combination of barrier methods and responsible behavioral choices that eliminate or significantly reduce exposure to the infectious chancre. Consistent and correct use of physical barriers during sexual contact is a primary line of defense. Latex or polyurethane condoms, for example, create a physical barrier to reduce the exchange of bodily fluids and limit skin-to-skin contact.
Condoms only protect the area of skin they cover, and their effectiveness against syphilis is limited by the location of the chancre. If a sore is located on an area such as the inner thigh not covered by the condom, transmission remains possible. For oral sex, using a dental dam—a thin sheet of latex or polyurethane—is recommended to create a barrier between the mouth and the vulva or anus. Using these barriers correctly and consistently for every sexual act, from start to finish, offers the greatest possible physical protection against the infection.
Modifying sexual behavior offers the strongest preventative measures. Abstinence from sexual contact is the only method that provides absolute protection against syphilis. For sexually active individuals, engaging in a long-term, mutually monogamous relationship with a partner who has been tested and confirmed to be uninfected dramatically lowers risk. Reducing the number of sexual partners lowers the likelihood of exposure. Alcohol and drug use should be avoided before or during sexual activity, as these substances can impair judgment and lead to riskier sexual practices.
The Importance of Regular Screening
Regular screening enables early detection and prompt treatment. Early detection through testing is vital because it prevents the infection from progressing to later, more damaging stages and stops further transmission to partners. Testing involves a simple blood test, using a two-step approach recommended by health organizations.
The Centers for Disease Control and Prevention (CDC) recommends routine screening for several populations considered to be at increased risk. This includes all pregnant individuals, who should be tested at their first prenatal visit to prevent the severe complications of congenital syphilis in newborns. Regular testing should also be sought by:
- Sexually active individuals with multiple partners.
- Those with HIV.
- Those living in areas with high syphilis prevalence.
Men who have sex with men (MSM) are advised to be screened at least annually, with testing frequency increasing to every three to six months for those who have multiple or anonymous partners. Anyone who has had unprotected sexual contact with a partner diagnosed with syphilis should seek testing and presumptive treatment immediately. Syphilis is curable with antibiotics, often a single injection of penicillin in its early stages, making the risk of long-term complications avoidable.