Subpages for Types of Common Sexually Transmitted Diseases (STDs)

Human Papillomavirus (HPV)

     Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) globally. There are over 200 types of HPV, some of which can cause genital warts, while others can lead to various cancers, including cervical, anal, throat, penile, and vaginal cancers. Most HPV infections are asymptomatic and clear on their own, but persistent infections with high-risk HPV types are a concern.

HPV and Anal Sex

          Anal sex is not limited to men who have sex with men.
          Women can also engage in it and both can be at risk of HPV-related anal diseases.
          HPV can lead to:

• Anal warts
• Abnormal cell growth in the anal canal
• Precancerous changes (AIN 1–3)
• Anal cancer if left untreated

 

 Signs and Symptoms: How do I know if I have HPV?

      Many people with HPV don’t experience any symptoms and may not know they are infected. When symptoms do appear, they depend on the type of HPV:

• Genital Warts: These are caused by low-risk HPV types (most commonly HPV 6 and 11). They can appear as single or multiple bumps that may be flat, raised, or cauliflower-shaped. They usually occur on or around the genitals, anus, or inner thighs. Warts are typically painless, but can sometimes itch, burn, or bleed.

• Cervical, Anal, or Other Cancers: High-risk HPV types (most commonly HPV 16 and 18) can cause cellular changes that may lead to cancer over time. These changes often have no symptoms in their early stages. Regular screening tests (like Pap smears for cervical cancer or anal Pap smears for anal cancer) are crucial for early detection. Symptoms of advanced cancer may include abnormal bleeding, pain, or changes in bowel habits, depending on the affected area.

  Risk Factors: Am I at risk for HPV?

      Anyone sexually active can get HPV. Risk factors include:

• Having multiple sexual partners.
• Having unprotected sex.
• A weakened immune system.

   How is HPV spread?

      HPV is primarily spread through skin-to-skin contact, typically during vaginal, anal, or oral sex. It can spread even when there are no visible warts or symptoms.

   Prevention: How can I reduce my risk of getting HPV?

       The most effective ways to reduce your risk of HPV are:

• Vaccination: The HPV vaccine is highly effective in preventing infection with the most common high-risk HPV types and those that cause genital warts. In Thailand, the Gardasil 9 vaccine is widely used and recommended for girls and boys aged 9 to 26.
• Condom Use: While condoms can reduce the risk of HPV transmission, they may not offer complete protection as HPV can infect areas not covered by a condom.
• Limiting Sexual Partners: Reducing the number of sexual partners can lower your risk of exposure.

  Testing and Diagnosis: Should I get tested for HPV?

         HPV testing is usually done as part of cervical cancer screening (Pap smear). If a Pap smear shows abnormal cells, an HPV test may be conducted. Anal Pap smears are recommended for individuals at higher risk of anal cancer, such as gay and bisexual men, and people living with HIV.

   Grading of Lesions

         Screening includes:

• Anal Pap smear to check for abnormal cells
• If abnormalities are found, lesions are graded as AIN 1 to AIN 3
  • AIN 3 has the highest risk of developing into anal cancer

 

  Treatment and Recovery

           There is no cure for the HPV virus itself, but the conditions it causes, such as genital warts and abnormal cell changes, can be treated.

• Genital Warts: Warts can be removed through various methods, including topical medications, cryotherapy (freezing), surgical excision, or laser therapy.
• Abnormal Cell Changes: Mild changes may be monitored, while more severe changes may require procedures like LEEP (Loop Electrosurgical Excision Procedure) to remove the affected tissue.

    Treatment & Follow-Up at WIH Hospital

           Our High-Resolution Anoscopy (HRA) procedure includes:

• RCI and Acetic Acid staining
• Visual examination (with or without colposcope)
• Electrocautery under local anesthesia or sedation

   Follow-Up Plan:

• AIN 1: Every 6–12 months
• AIN 2: Every 6 months
• AIN 3: Close monitoring

 💉 HPV Vaccination Available at WIH

              The HPV vaccine is a safe and effective way to prevent:

• Cervical cancer
• Anal cancer
• Genital warts

        🌈 Recommended for:

• All genders (ages 9–45)
• Especially important for those who engage in anal sex

LGBTQ+ individuals and couples

Can I get HPV again after treatment?

         Yes, treatment addresses the symptoms, but it does not eliminate the virus from your body, meaning you can experience recurrence of warts or abnormal cell changes. You can also get infected with new types of HPV if exposed.

 

 HIV (Human Immunodeficiency Virus)

      Human Immunodeficiency Virus (HIV) is a virus that attacks the body’s immune system. If left untreated, it can lead to Acquired Immunodeficiency Syndrome (AIDS), the most advanced stage of HIV infection. HIV weakens the body’s ability to fight off infections and certain cancers.

Signs and symptoms: How do I know if I have HIV?

           HIV infection progresses in stages, and symptoms can vary:

• Acute HIV Infection (2-4 weeks after exposure): Many people experience flu-like symptoms, including fever, rash, sore throat, swollen lymph glands, headaches, muscle aches, and fatigue. These symptoms can be mild and easily mistaken for other illnesses.
• Clinical Latency (Asymptomatic HIV Infection): During this stage, HIV is still active but reproduces at very low levels. People may have no symptoms for many years.
• AIDS (Acquired Immunodeficiency Syndrome): This is the most severe stage of HIV infection. The immune system is severely damaged, making the person highly vulnerable to opportunistic infections (infections that a healthy immune system could normally fight off) and certain cancers. Symptoms can include rapid weight loss, recurring fever, night sweats, extreme tiredness, prolonged swelling of lymph glands, chronic diarrhea, sores of the mouth, anus, or genitals, pneumonia, and neurological disorders.

 Risk Factors

          HIV is transmitted through specific bodily fluids (blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk) from a person with HIV. You are at risk if you:

• Have vaginal or anal sex without a condom with someone who has HIV.
• Share needles or syringes with someone who has HIV.
• Are born to an HIV-positive mother (mother-to-child transmission).
• Receive contaminated blood transfusions or organ transplants (though this is rare in countries with robust screening).

 

 What is the link between HIV and other STIs like syphilis?

      Having another STI, such as syphilis, can increase your risk of acquiring HIV. Syphilis sores, for example, provide an easy entry point for HIV into the body. Additionally, the same behaviors that put you at risk for other STIs can also increase your risk for HIV.

 How is HIV spread?

          HIV is spread through direct contact with certain bodily fluids of a person with a detectable viral load. This includes:

• Unprotected sexual contact: Vaginal or anal sex without condoms.
• Sharing needles or drug injection equipment.
• Mother-to-child transmission: During pregnancy, childbirth, or breastfeeding.

           You cannot get HIV through casual contact, air, water, or insects.

        Prevention: How can I reduce my risk of getting HIV?

• Consistent and Correct Condom Use: Using condoms every time you have sex significantly reduces the risk.
• PrEP (Pre-Exposure Prophylaxis): A daily medication taken by HIV-negative individuals at high risk to prevent HIV infection.
• PEP (Post-Exposure Prophylaxis): Emergency medication taken within 72 hours after potential HIV exposure to prevent infection.
• HIV Testing and Treatment: For individuals living with HIV, adhering to ART can suppress the viral load to an undetectable level, making it impossible to transmit HIV sexually (Undetectable = Untransmittable or U=U).
• Not Sharing Needles: Using new, sterile needles for injecting drugs.

  Testing and Diagnosis

           Regular HIV testing is crucial, especially if you are sexually active or have risk factors. You should get tested if:

• You are a sexually active gay or bisexual man.
• You have had unprotected sex with a new partner or multiple partners.
• You have shared needles.
• You are pregnant (all pregnant women should be tested).
• You are taking PrEP.

 Treatment and Recovery

    Currently, there is no cure for HIV, but effective antiretroviral therapy (ART) can manage the virus, allowing people with HIV to live long, healthy lives and preventing transmission.

  Can I get HIV again after receiving treatment?

    While ART can effectively control HIV, it does not clear the virus from your body. Therefore, you cannot get “re-infected” with the same strain of HIV once you have it. However, if you are exposed to a different strain of HIV, superinfection can occur, which may complicate treatment. The goal of ART is to suppress the virus, maintain your health, and prevent transmission.

 

Chlamydia

       Chlamydia is a common sexually transmitted infection (STI) caused by bacteria Chlamydia trachomatis. It often has no symptoms, which means many people are unaware they are infected and can unknowingly transmit it to others. If left untreated, chlamydia can lead to serious health problems, especially for women, including infertility.

Signs and symptoms: How do I know if I have Chlamydia?

          Chlamydia is often called a “silent” infection because most people do not have symptoms. If symptoms do occur, they may not appear until several weeks after sexual contact.

            Symptoms in women may include:

• Abnormal vaginal discharge.
• Burning sensation when urinating.
• Pain during sex.
• Abdominal pain.
• Bleeding between periods.
• Rectal pain, discharge, or bleeding.

            Symptoms in men may include:

• Discharge from the penis.
• Burning sensation when urinating.
• Pain or swelling in one or both testicles (less common).
• Rectal pain, discharge, or bleeding.

 Risk Factors: Am I at risk for Chlamydia?

            Anyone sexually active can get chlamydia. Risk factors include:

• Having multiple sexual partners.
• Having unprotected sex.
• Being under 25 years old (chlamydia is more common in younger sexually active individuals).
• Having a previous STI.

 How is Chlamydia spread?

   Chlamydia is spread through vaginal, anal, or oral sex with someone who has the infection.

 Prevention: How can I reduce my risk of getting Chlamydia?

          The only way to completely avoid STIs is not to have vaginal, anal, or oral sex. If you are sexually active, you can lower your chances by:

• Consistent and Correct Condom Use: Using condoms every time you have sex.
• Mutual Monogamy: Being in a long-term, mutually monogamous relationship with a partner who has been tested and does not have chlamydia.
• Regular Testing: Getting tested regularly, especially if you have new partners or multiple partners.

Testing and Diagnosis: Should I get tested for Chlamydia?

         Yes, regular testing is recommended if you are sexually active, especially if you:

• Are sexually active men and women under the age of 25.
• Have new or multiple sexual partners.
• Have symptoms suggestive of chlamydia.

Chlamydia is usually diagnosed with a urine test or a swab from the affected area (cervix, vagina, urethra, rectum, or throat).

Treatment and Recovery

   Is there a cure for Chlamydia?

            Yes, chlamydia is curable with antibiotics. It is important to complete the entire course of medication, even if symptoms disappear, to ensure the infection is fully treated.

  Can I get Chlamydia again after receiving treatment?

           Yes, having chlamydia once does not protect you from getting it again. You can get re-infected if you have sexual contact with an infected partner. Both you and your partner(s) should be treated to prevent re-infection. It’s recommended to wait 7 days after treatment is completed by both partners before having sex again.

 

 Gonorrhea

    Gonorrhea is a common sexually transmitted infection (STI) caused by bacteria, Neisseria gonorrhoeae. Like chlamydia, it often has no symptoms, leading to silent transmission. If untreated, gonorrhea can lead to serious complications, including pelvic inflammatory disease (PID) in women, which can cause infertility and ectopic pregnancy, and epididymitis in men, which can cause infertility.

 Signs and symptoms: How do I know if I have Gonorrhea?

        Many people with gonorrhea do not have symptoms. If symptoms do occur, they typically appear 1 to 14 days after infection.

• Painful urination
• Pus-like discharge from the penis
• Pain or swelling in one testicle
• Increased vaginal discharge
• Vaginal bleeding between periods
• Abdominal pain
• Anal itching
• Soreness
• Bleeding
• Painful bowel movements

  Risk Factors

        Anyone sexually active can get gonorrhea. Risk factors include:

• Having multiple sexual partners.
• Having unprotected sex.
• Being a young sexually active individual (especially aged 15-24).
• Having a previous STI.
• Individuals with HIV.

  How is Gonorrhea spread?

    Gonorrhea is spread through vaginal, anal, or oral sex with someone who has the infection.

 Prevention: How can I reduce my risk of getting Gonorrhea?

         The only way to completely avoid STIs is not have vaginal, anal, or oral sex. If you are sexually active, you can lower your chances by:

• Consistent and Correct Condom Use: Using condoms every time you have sex.
• Mutual Monogamy: Being in a long-term, mutually monogamous relationship with a partner who has been tested and does not have gonorrhea.
• Regular Testing: Getting tested regularly, especially if you have new partners or multiple partners.

Testing and Diagnosis: Should I get tested for Gonorrhea?

         Yes, regular testing is recommended if you are sexually active, especially:

• A sexually active young adult.
• Have new or multiple sexual partners.
• Have symptoms suggestive of gonorrhea.

Gonorrhea is usually diagnosed with a urine test or a swab from the affected area (cervix, vagina, urethra, rectum, or throat).

 Treatment and Recovery

           Is there a cure for Gonorrhea?

           Yes, gonorrhea is curable with antibiotics. However, due to increasing antibiotic resistance, it’s crucial to receive the correct and most effective treatment prescribed by a healthcare provider. It is important to complete the entire course of medication.

          Can I get Gonorrhea again after receiving treatment?

          Yes, having gonorrhea once does not protect you from getting it again. You can get re-infected if you have sexual contact with an infected partner. Both you and your partner(s) should be treated to prevent re-infection.     

 

Herpes Simplex Virus (HSV)

    Herpes Simplex Virus (HSV) is a common viral infection that causes sores, most often around the mouth or genitals. There are two main types:

• HSV-1 (Oral Herpes): Primarily causes oral herpes (cold sores or fever blisters) but can also cause genital herpes through oral-genital contact.
• HSV-2 (Genital Herpes): Primarily causes genital herpes.

Herpes is a lifelong infection, meaning the virus stays in the body even when there are no visible sores.

 Signs and symptoms

        Many people with herpes are asymptomatic or have very mild symptoms that go unnoticed or are mistaken for other conditions, such as insect bites or pimples. When symptoms appear, they can include:

• Prodromal Symptoms: Tingling, itching, or pain in the area where sores will appear, occurring a few hours to a day before an outbreak.
• Blisters/Sores: Small, painful blisters that may break open to form shallow ulcers. These can appear on or around the genitals, anus, mouth, or other areas of skin contact.
• Flu-like Symptoms : Fever, body aches, swollen lymph nodes, headache.
• Painful Urination: If sores are near the urethra.

 Risk Factors

         Anyone sexually active can get genital herpes. Risk factors include:

• Having multiple sexual partners
• Having unprotected sex
• Having other STIs

  How is Herpes spread?

         Herpes is spread through direct contact with herpes sores, saliva, or genital secretions from a person who has the virus. This can happen during:

• Vaginal, anal, or oral sex.
• Kissing (for oral herpes).
• Skin-to-skin contact with infected areas, even if no visible sores are present (asymptomatic shedding).

Prevention: How can I reduce my risk of getting herpes?

         The only way to completely avoid STIs is to not have vaginal, anal, or oral sex. If you are sexually active, you can lower your chances by:

• Avoiding Sexual Contact During Outbreaks: Do not have sex if you or your partner has visible sores or prodromal symptoms.
• Consistent and Correct Condom Use: Condoms can reduce the risk, but they do not offer complete protection, as the virus can be on skin areas not covered by the condom.
• Daily Antiviral Medication: If you have herpes, taking daily antiviral medication (suppressive therapy) can reduce the frequency of outbreaks and lower the risk of transmission to partners.
• Disclosure: Having open and honest conversations with partners about herpes status.

Testing and Diagnosis

         Testing for herpes is typically done when a person has visible sores. A healthcare provider can take a swab from the sore for testing. Blood tests can detect HSV antibodies, indicating past exposure, but they cannot determine the exact location of the infection or if it’s currently active. Routine screening for HSV in asymptomatic individuals is generally not recommended unless there is a specific concern or risk factor.

 Treatment and Recovery

          Is there a cure for Herpes?

          There is no cure for herpes, but antiviral medications can help manage outbreaks, reduce their frequency and severity, and lower the risk of transmission.

          Can I get Herpes again after receiving treatment?

          Once you are infected with HSV, the virus stays in your body. Treatment helps manage outbreaks, but it does not eliminate the virus. You can experience recurrent outbreaks, although they often become less frequent and less severe over time.

 

 Hepatitis B (HBV)

      Hepatitis B is a serious liver infection caused by the Hepatitis B virus (HBV). It can cause both acute (short-term) and chronic (long-term) illness. Chronic Hepatitis B can lead to severe liver damage, including cirrhosis, liver failure, and liver cancer, and can be life-threatening. A safe and effective vaccine is available to prevent Hepatitis B.

 Signs and Symptoms: How do I know if I have Hepatitis B?

         Many people with acute Hepatitis B, especially children, may not experience any symptoms. When symptoms do occur, they can range from mild to severe and typically appear 1 to 4 months after exposure:

• Fever
• Fatigue
• Loss of appetite
• Nausea and vomiting
• Abdominal pain (especially in the upper right side)
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice (yellowing of the skin and whites of the eyes)

Chronic Hepatitis B often has no symptoms for many years until significant liver damage has occurred.

 Risk Factors: Am I at risk for Hepatitis B?

          Hepatitis B is primarily spread through blood, semen, and other bodily fluids. You are at risk if you:

• Have unprotected sex with an infected person.
• Share needles, syringes, or drug preparation equipment.
• Share personal items like razors or toothbrushes with an infected person.
• Are born to an infected mother.
• Have occupational exposure to blood (e.g., healthcare workers).
• Receive blood transfusions or organ transplants from an infected donor (rare in countries with screening).

 How is Hepatitis B spread?

          Hepatitis B is spread when blood, semen, or other body fluids from a person infected with the Hepatitis B virus enter the body of someone who is not infected. This can occur through:

• Sexual contact.
• Sharing needles or syringes.
• Mother-to-child transmission during birth.
• Sharing personal items that may have traces of blood (e.g., razors, toothbrushes).
• Needle sticks or sharps exposures in healthcare settings.

Hepatitis B is not spread through food, water, casual contact, or by sharing eating utensils.

  Prevention: How can I reduce my risk of getting Hepatitis B?

• Vaccination: The Hepatitis B vaccine is highly effective and provides long-term protection.
• Safe Sex Practices: Use condoms consistently and correctly during sexual activity.
• Avoid Sharing Needles: Never share needles, syringes, or other drug injection equipment.
• Do Not Share Personal Items: Avoid sharing razors, toothbrushes, or nail clippers.
• Safe Injection Practices: For healthcare workers, adhere to universal precautions and safe injection practices.

Testing and Diagnosis: Should I get tested for Hepatitis B?

           Testing for Hepatitis B involves blood tests to detect HBV antigens and antibodies, which can determine if you have an active infection, a past infection, or are immune. Testing is recommended for:

• Individuals with risk factors for HBV.
• Pregnant women.
• People born in regions with high HBV prevalence.
• Healthcare workers.
• People with liver disease.

Treatment and Recovery

         Is there a cure for Hepatitis B?

         There is no cure for chronic Hepatitis B, but antiviral medications can help manage the infection, slow down liver damage, and reduce the risk of developing liver cancer. For acute Hepatitis B, treatment typically focuses on supportive care as the body fights off the infection.

         Can I get Hepatitis B again, after receiving treatment?

         If you have successfully cleared an acute Hepatitis B infection or are vaccinated, you develop protective antibodies and are generally immune to future infections. However, if you have chronic Hepatitis B, you will always carry the virus, and the goal of treatment is to manage it, not to eliminate it.

 

 Hepatitis C (HCV)

       Hepatitis C is a liver infection caused by the Hepatitis C virus (HCV). Most people who become infected with HCV develop a chronic infection, which can lead to serious liver problems over time, including cirrhosis, liver failure, and liver cancer. Unlike Hepatitis B, there is currently no vaccine for Hepatitis C, but highly effective antiviral medications can cure the infection for most people.

  Signs and Symptoms: How do I know if I have Hepatitis C?

           Many people with Hepatitis C, especially in the early stages, have no symptoms and may not know they are infected until significant liver damage has occurred. When symptoms do appear, they can be mild and non-specific:

• Fatigue
• Fever
• Nausea or poor appetite
• Abdominal pain
• Dark urine
• Clay-colored bowel movements
• Joint pain
• Jaundice (yellowing of the skin and whites of the eyes)

Symptoms of chronic HCV may include those listed above, as well as signs of advanced liver disease such as fluid retention, easy bleeding/bruising, and confusion.

 Risk Factors: Am I at risk for Hepatitis C?

          Hepatitis C is primarily spread through contact with blood from an infected person. You are at risk if you:

• Share needles, syringes, or other drug injection equipment.
• Received blood transfusions or organ transplants before 1992 (when widespread HCV screening began).
• Have certain medical conditions (e.g., hemodialysis).
• Have occupational exposure to blood (e.g., healthcare workers).
• Are born to an HCV-infected mother.
• Have unprotected sex with multiple partners, especially if involving activities that could lead to blood exposure.

 How is Hepatitis C spread?

          Hepatitis C is spread through blood-to-blood contact. The most common ways are:

• Sharing needles or other equipment for injecting drugs.
• Less commonly, through sexual contact, especially among those with multiple partners, other STIs, or practices that can involve blood.
• Needle stick injuries in healthcare settings.

 Prevention: How can I reduce my risk of getting Hepatitis C?

          Since there is no vaccine for Hepatitis C, prevention focuses on avoiding blood-to-blood contact:

• Never Share Needles: Do not share any equipment used for injecting drugs.
• Safe Sex Practices: While sexual transmission is less common, using condoms can reduce risk, particularly if engaging in practices that might involve blood.
• Do Not Share Personal Items: Avoid sharing razors, toothbrushes, nail clippers, or other items that might have blood on them.
• Ensure Sterile Procedures: If getting tattoos or piercings, ensure the facility uses sterile equipment.
• Screening Blood and Organs: Strict screening of blood and organ donations has made transmission through these routes very rare.

 Testing and Diagnosis

          Testing for Hepatitis C is done through blood tests that detect HCV antibodies (indicating exposure) or HCV RNA (indicating active infection). Testing is recommended for:

• Anyone who has ever injected drugs
• People who received blood transfusions or organ transplants before 1992
• Healthcare workers
• People with HIV
• Individuals with signs of liver disease
• Anyone with ongoing risk factors

 Treatment and Recovery

          Is there a cure for Hepatitis C?

         Yes, Hepatitis C is curable for most people with direct-acting antiviral (DAA) medications. These medications typically involve a short course (8-12 weeks) of oral pills with high cure rates (over 95%).

        Can I get Hepatitis C again, after receiving treatment?

Yes, being cured of Hepatitis C does not protect you from getting it again. You can be re-infected if you are exposed to the virus again, such as by sharing needles or having unprotected sex with an infected person. It is important to continue practicing preventive measures even after successful treatment.

 

Syphilis

  Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. It can cause serious health problems without treatment. Infection develops in stages (primary, secondary, latent, and tertiary). Each stage can have different signs and symptoms. If left untreated, it can lead to severe damage to internal organs and can even be fatal.

Signs and Symptoms: How do I know if I have syphilis?

        Each stage of syphilis has different signs and symptoms.

         Primary Stage During the primary stage of syphilis, you may notice a single sore or multiple sores, called chancres. The sore is the location where syphilis entered your body. These chancres usually occur in, on, or around the:

• Penis
• Vagina
• Anus
• Rectum
• Lips or in the mouth

        Sores are usually firm, round, and painless. Because the sore is painless, you may not notice it. The sore usually lasts 3 to 6 weeks and heals regardless of whether you receive treatment. Even after the sore goes away, you must still receive treatment. This will stop your infection from moving to the secondary stage.

        Secondary Stage During the secondary stage, you may have skin rashes and/or sores in your mouth, vagina, or anus. This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can be on the palms of your hands and/or the bottoms of your feet and look:

• Rough
• Red
• Reddish-brown
• Fever
• Swollen lymph glands
• Sore throat
• Patchy hair loss
• Headaches
• Weight loss
• Muscle aches
• Fatigue (feeling very tired)

         The symptoms from this stage will go away whether you receive treatment. Without the right treatment, your infection will move to the latent and possibly tertiary stages of syphilis.

        Latent Stage The latent stage of syphilis is a period when there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years.

       Tertiary Stage: Most people with untreated syphilis do not develop tertiary syphilis. However, it can affect many different organ systems. These include the heart and blood vessels, the brain, and the nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began. In tertiary syphilis, the disease damages your internal organs and can result in death.

        Neurosyphilis, Ocular Syphilis, and Otosyphilis. Without treatment, syphilis can spread to the brain and nervous system (neurosyphilis), the eye (ocular syphilis), or the ear (otosyphilis). This can happen during any of the stages described above.

       Signs and symptoms of neurosyphilis can include:

• Severe headache
• Muscle weakness and/or trouble with muscle movements
• Changes to your mental state (trouble focusing, confusion, personality change) and/or dementia (problems with memory, thinking, and/or decision making).

       Signs and symptoms of ocular syphilis can include:

• Eye pain and/or redness
• Changes in your vision or even blindness

      Signs and symptoms of otosyphilis may include:

• Hearing loss
• Ringing, buzzing, roaring, or hissing in the ears (“tinnitus”)
• Dizziness or vertigo (feeling like you or your surroundings are moving or spinning)

  Risk Factors: Am I at risk for syphilis?

        Sexually active people can get syphilis through vaginal, anal, or oral sex without a condom with a partner who has syphilis.

        If you are sexually active, have an honest and open talk with your healthcare provider. Ask them if you should get tested for syphilis or other STIs.

        Syphilis may be more common in some racial/ethnic and sexual minority groups. For instance, gay and bisexual men are disproportionately impacted by syphilis. In addition, people from racial and ethnic minority groups are experiencing the brunt of the congenital syphilis epidemic. These disparities are due to social, cultural, and economic conditions that make it difficult for sexually active people to stay healthy.

 What is the link between syphilis and HIV?

          Having a sore or break in the skin from an STI, such as syphilis, may allow HIV to more easily enter your body. You may also be more likely to get HIV because the same behaviors and circumstances that put you at risk for getting other STIs can also put you at greater risk for getting HIV.

How is syphilis spread?

         You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex.

         You cannot get syphilis through casual contact with objects, such as:

• Toilet seats
• Doorknobs
• Swimming pools
• Hot tubs
• Bathtubs
• Sharing clothing or eating utensils

 Prevention: How can I reduce my risk of getting syphilis?

         The only way to completely avoid STIs is not to have vaginal, anal, or oral sex.

         If you are sexually active, you can do the following things to lower your chances of getting syphilis:

• Being in a long-term mutually monogamous relationship with a partner who has been tested and does not have syphilis.
• Using a Condom is the right way every time you have sex. Condoms prevent the spread of syphilis by preventing contact with a sore. Sometimes sores occur in areas not covered by a condom. Contact with these sores can still transmit syphilis.
• Avoid recreational drugs or excessive alcohol consumption, as these can impair judgment and lead to risky sexual behaviors.

Testing and Diagnosis: Should I get tested for syphilis?

         Should get tested regularly for syphilis if you are sexually active and:

• Are a gay or bisexual man
• Have HIV
• Are taking pre-exposure prophylaxis (PrEP) for HIV prevention
• Have partner(s) who have tested positive for syphilis
• Have certain risk factors for syphilis, like living in a community with high rates of syphilis

         Syphilis is typically diagnosed with a blood test. If a sore is present, fluid from the sore may also be tested.

Treatment and Recovery

       Is there a cure for syphilis?

       Yes, syphilis is curable with the right antibiotics from the healthcare provider. Penicillin is the preferred treatment. However, treatment might not undo any damage the infection can cause, especially if the disease has progressed to later stages.

       Can I get syphilis again, after receiving treatment?

       Having syphilis once does not protect you from getting it again. Even after successful treatment, you can get syphilis again. Only laboratory tests can confirm whether you have syphilis. Follow-up testing by your healthcare provider is necessary to make sure your treatment was successful.

       It may not be obvious that a sex partner has syphilis. Syphilis sores in the vagina, anus, mouth, or under the foreskin of the penis, can be hard to see. You may get syphilis again if your sex partner(s) do not receive testing and treatment.