Syphilis. Get Tested. Get Treated. Tell your partners.

We've seen a dramatic increase in syphilis infections over the past five years in Toronto. Before 2002, the city averaged about 35 infectious syphilis cases each year. In 2004, there 376 new infections. Almost all infections have been among men, and gay and bisexual men have made up three quarters of these infections.

Infections began to drop in 2005 and stayed fairly level in 2006.
The number of new cases is still far too high and is climbing again (253 cases in 2006, 273 cases in 2007 and 317 cases in 2008). This is seven times higher than the levels before 2002.

It's still mostly gay and bisexual men who are getting syphilis. Plus, 45% of the cases are amongst men who are HIV-positive. This is up significantly from previous years (where about 30% of people with infectious syphilis were also HIV positive). It's important to get tested - and treated - as syphilis is much easier than HIV to get or pass on. If you are HIV-positive, syphilis can make you very sick.






Don't wait for someone to tell you that you may have been exposed to syphilis. You can get a blood test for syphilis from your doctor, at a Sexual Health Clinic, or at Hassle Free Men’s Clinic (416-922-0603) here in Toronto.


What is syphilis?
How is syphilis spread?
How do I know if I have it?
Can syphilis be cured?
How can I find out if I have syphilis?
How can I protect myself?
What if I have HIV?
Does syphilis increase the risk of HIV infection?
Where can I get a syphilis test?
More information about syphilis or where to get tested
Syphilis Awareness Campaign Materials


Syphilis is a sexually transmitted infection (STI). It goes through three different stages after infection, with different symptoms at each stage.

It’s spread when your skin (especially mucous membranes like your throat, penis and ass) comes into direct contact with syphilis sores or rashes. It can be spread through oral sex (sucking or getting sucked), anal sex (fucking or getting fucked) or vaginal sex.

You may have syphilis and not know it. But, you can still get very sick from syphilis and give syphilis to others. If you are HIV-positive and you have been infected for some time, it may be more difficult to treat syphilis. It's also possible for syphilis infection to advance more quickly and have more serious side effects if you are HIV-positive.

About three weeks after you have sex with someone who has syphilis, you may notice a painless sore (called a ‘chancre’) on your penis, near your anus (ass, bum), or in your throat. The sore may go away by itself after 3-6 weeks; however you are still infected with syphilis. And, it’s very easy to pass on syphilis to someone at this stage of infection. This is referred to as the "primary" stage.

Four to 10 weeks after the sore appears, you may notice a red rash on your chest, palms and the soles of your feet. You might also have muscle and joint pain, fever and patchy hair loss. These symptoms may also disappear without treatment, but you can still pass on syphilis to your sex partners. This is referred to as the "secondary" stage.

Finally, there is a long period without any symptoms. However, the syphilis bacteria continue to live in your body and can cause serious damage to your heart, brain, eyes and bones. It may take up to 10-30 years before this damage is seen but can occur much earlier if you also have HIV. Fortunately, syphilis can be detected and treated before it reaches this stage, often referred to as the late (tertiary) stage.

What's of great concern has been the appearance of cases of tertiary syphilis amongst HIV-positive men, within a very short period of time (six months after initial infection, as opposed to the 10-30 years).

Yes. Caught early, syphilis can be easily treated.

The most common means of detecting syphilis is through a blood test. Your doctor or the lab may also be able to examine fluid from the sore under a microscope (if a sore is present). If you are HIV-positive, it may be more difficult to detect syphilis in your blood. In this case, your doctor should also ask for a "confirmatory" test.

Use a latex condom when you have anal sex. This can protect you when the condom covers up the sores caused by syphilis. Condoms also protect against HIV. You can also use a condom when you have oral sex to provide protection. There are flavoured and dry (non-lubricated) condoms available for oral sex.

Get regularly tested for syphilis if you have sex with other men, especially if you enjoy oral or anal sex. Talk to your doctor about your sex life and how often you should be tested for syphilis (and other STIs). Even if you’ve had syphilis once you can get it again.

If someone you had sex with in the last 3 months tells you they have syphilis, get tested. Even if the test is negative for syphilis, you should be treated – you might be infected but the syphilis has yet to show up in the test.


If you're HIV-positive you may have a weakened immune system which can make you more likely to pick up syphilis. Symptoms of syphilis may be more severe, it may progress quickly to later stages, and it may take longer to treat and cure. Syphilis may increase your 'viral load' (a measure of HIV in your blood) - this can quicken the rate at which HIV damages your immune system. It also can make you more likely to transmit HIV to sexual partners. If you're HIV positive and have syphilis, your syphilis can be more easily spread to sexual partners, as your immune system may be less able to control the amount of syphilis bacteria in the body.

Doctors do not routinely test HIV positive people for syphilis; if you're HIV-positive you should specifically ask your doctor for a test.


Yes. Syphilis causes sores and rashes, so it's easier to get infected with HIV during sexual activity. There is a greater risk of passing HIV from an HIV positive person to an HIV negative person if either of them has syphilis. When a person has an infection like syphilis -- or any other sexually transmitted infection (STI) -- there is an increase in the number of white blood cells in the infected mucous area. HIV can attach to these cells and get into the bloodstream causing HIV infection. Your risk for HIV infection is increased 3-4 more times if your sexual partner is infected with syphilis and is HIV-positive.

Don't wait for someone to tell you that you may have been exposed to syphilis. You can get a blood test for syphilis from your doctor, at a Sexual Health Clinic, or at Hassle Free Men’s Clinic (416-922-0603) here in Toronto.

In Ontario call: AIDS and Sexual Health Infoline: 416-392-2437 or 1-800-668-2437. Online Resources (For Toronto and other places in Ontario):




Look What's Back Booklet (more detailed info on syphilis) (PDF)

"Look What's Back" posters (PDF)

"Syphilis. Get tested. Get Treated." poster (PDF)





This project is a partnership between the AIDS Committee of Toronto (ACT), Hassle Free Clinic and Toronto Public Health, in collaboration with Asian Community AIDS Services, the Alliance for South Asian AIDS Prevention, the Black Coalition for AIDS Prevention, the Centre for Spanish-speaking Peoples AIDS Program, and VIVER (Portuguese-speaking HIV/AIDS Coalition).

Updated October 2008

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what's on

• AIDS Walk for Life Toronto: Register. Pledge. Walk. Register on-line at aidswalkforlifetoronto.ca


• ACT Furniture Bank: Summer Hours - July 2009.


• Condom Stuffing parties: Next date - Tuesday July 14, 6:00 to 8:30 p.m.


• 2009 Retreat for Women with HIV/AIDS. Applications now being accepted (deadline is July 31, 2009).

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