Cases of syphilis have been on the rise in Germany for several years, especially among gay men. Can men protect themselves and what can they do if they do catch it?
French disease, lues, lust epidemic, hard chancre - the disease has had many different names over the centuries and is currently more topical than ever. Because the number of infections is rising. "We have been dealing with syphilis continuously in recent years and it is almost exclusively men who have sex with men," says Dr Stefan Fenske from the Infection Medicine Centre Hamburg. To be more precise, it is particularly men with changing sexual partners.
So what symptoms should set alarm bells ringing?
"That's the tricky thing about syphilis," explains Fenske. "Because often there are no symptoms at all or completely unspecific symptoms such as fever, joint pain and loss of appetite. You should become aware if a non-itchy ulcer heals badly and is located on a part of the body that you come into contact with during sex - such as the bum, cock and throat."
However, many infections are discovered by chance when blood tests are carried out for other reasons. "HIV-positive patients have an advantage to a certain extent," says Fenske. This is because their blood is checked regularly every three months as part of their treatment, so that abnormal changes in liver values, for example, are automatically recognised.
The syphilis infection in Andreas* was also discovered in this way. He had not noticed any symptoms either. However, he was not particularly shocked by this chance finding. "After my HIV diagnosis, nothing knocks me for six. Hepatitis C, which is much more difficult to treat, would have affected me more," he admits.
Syringes in the arse
The standard treatment for syphilis is an injection in each buttock. Fenske says that this is usually always successful. Treatment only needs to be extended if the infection has been present for over a year. Fortunately, it's a fairly simple and straightforward procedure. "The injection was extremely painful for me, though. But I thought at the time: Well, a little punishment is a must," says Andreas and laughs.
However, the whole thing has also made him think about his sexual behaviour. Andreas' viral load has been below the detection limit for a long time, which means he is no longer infectious. He is therefore increasingly skipping the condom during sex. "That's the downside of the new freedom: I can no longer transmit HIV, but I can catch other things." Of course, condoms only offer a certain degree of protection against syphilis infection when having sex. "However, the pathogen can also be transmitted through blow jobs or intensive kissing if the partner has an infectious spot on the cock or in the throat, for example," Stefan Fenske points out. The same also applies to gonorrhoea and chlamydia. And once you have recovered from syphilis, there is no immune effect, i.e. you can become infected again. The next case of syphilis may already be lurking at your next sex date.
However, this does not mean that Andreas will abstain from sex in future. For him, the risk of reinfection is "a general business risk", as he jokingly puts it. However, he takes his responsibility towards his sexual partners very seriously. When he found out about his syphilis infection, he contacted men he had had sex with in recent weeks and whom he could contact. "Because someone might be walking around with syphilis for a long time without realising it and infecting others."
Stefan Fenske and ICH WEISS WAS ICH TU (I KNOW WHAT I DO) therefore recommend this to anyone who has multiple sexual partners, regularly test themselves for syphilis to leave. Better safe than sorry.
Further information at https://www.iwwit.de/wissenscenter/sti/syphilis
*Name changed
