There are certain risk factors that increase your chances of contracting syphilis. Read on to learn more about them and how the bacterium is passed from one person to the next so you can take precautions to protect yourself.
Common Causes
Sexual contact is the main way that people get syphilis. A pregnant mother can also pass it to her baby.
Sexual Contact
Sexual transmission of syphilis infection occurs when skin or mucosal tissue comes in contact with an open, ulcerative sore known as a chancre. The corkscrew shape of the bacteria allows it to burrow into the mucous membranes of the mouth, vagina, or rectum or to enter microscopic breaks in the skin.
If it’s not treated, syphilis will go through four stages of infection: primary, secondary, latent, and tertiary.
The risk and mode of transmission can vary by the stage:
During primary syphilis, the disease is passed by coming into contact with sores that may be firm round or painless. During secondary syphilis, the disease can be passed by coming into contact with the secondary rash. During latent syphilis, there are no signs of symptoms and the infection generally can not be spread. During tertiary syphilis, the disease has spread to other organs and is likely highly contagious at this point.
Syphilis cannot be passed via toilet seats, casual contact, or shared use of utensils or personal care items. This is because T. pallidum has a fragile shell that lacks the components needed to sustain it outside of the body for very long.
Mother to Child
The perinatal transmission of syphilis, also known as congenital syphilis, occurs when the syphilis bacteria in a pregnant mother penetrates the placenta surrounding the developing fetus.
While this can happen during any stage of pregnancy, the likelihood is highest during the second half. The risk of transmission varies by the mother’s stage of infection.
Lifestyle Risk Factors
While syphilis can affect anyone, there are a number of risk factors that can increase your likelihood of infection.
Among the most common risk factors are:
Inconsistent condom use: This is the main cause of transmission in all groups. According to a study by the CDC, only around 24% of females and 33% of males between the ages 15 and 44 use a condom consistently. Multiple sex partners: This places you at risk due to increased chances of exposure. This is especially true among anonymous partners who meet on online platforms. Gay, bisexual, and other men who have sex with men (MSM): These individuals account for approximately half of primary and secondary syphilis infections in the United States. Physiological vulnerabilities—such as the fragility of rectal tissues—and high rates of HIV place MSM at an inherently increased risk compared to heterosexual peers. Injecting drug use has given rise to a spate of STI outbreaks. Although syphilis is rarely transmitted by blood-to-blood exposure, injecting drug use can impair judgment and increase the risk of sexual violence or the exchange of sex for drugs.
Avoidance of Screening
Perhaps one of the greatest obstacles to detecting and treating syphilis infection is avoidance of STI screening. This can be for a variety of reasons.
Some people may not get tested due to lack of access to health care, while others may be unaware of the screening guidelines.
Others may actively ignore them. Reasons for avoiding tests can include stigma or the fear of receiving a concurrent HIV diagnosis. This translates to an increased risk of infection, as well as reinfection.
A 2015 study from the University of California, Los Angeles reported that between 6% and 8% of MSM previously infected with syphilis experienced a repeat infection within two years. Many of those who had delayed testing until secondary infection admitted that they either didn’t want to know or were afraid to learn the results.
Young African American males are 62% less likely to be tested if they associate STIs with immorality, shame, uncleanliness, or a weakness of character. Today, the rate of syphilis among African Americans is nearly five times that of whites.
Testing Guidelines
The CDC now recommends at least once-a-year testing for syphilis, chlamydia, and gonorrhea for all sexually active gay men, bisexual men, and other men who have sex with men.All sexually active persons with HIV should also be screened for these STIs at their initial HIV care visit and at least annually during the course of their care.
Additionally, pregnant women should be tested for syphilis at their first prenatal visit.
All sexually active gay and bisexual men who have multiple or anonymous sex partners should be screened more often (e.g., at three- to six-month intervals).
Not adhering to these guidelines can increase your chances of having an undetected case of syphilis that then gets passed on to partners.
A Word From Verywell
When it comes to your health, be honest with yourself about your risk and do what you can to protect yourself and anyone who you could potentially expose to infection.
If expense is making you hesitate getting tested, look into some of the ways to get tested for STIs for free or at reduced cost.
