Sexually transmitted infections have been around for thousands of years – the National Institutes of Health notes that there is evidence of gonorrhea from 3,500 years ago – and can cause significant damage to a person’s health. But the introduction of antibiotics in the 20th century gave us a way to fight these infections, and measures such as condom use and regular STI testing can help combat the spread of these diseases today.
SYPHILIS
The first recorded outbreak of syphilis happened more than 500 years ago, in Naples, Italy, though the exact origin of the disease is unknown. While there are effective treatments for syphilis, and it can be cured, there has been an uptick in cases in the U.S.
“Syphilis has made a comeback, and that’s been for years now,” said Anitra Branch, director of outreach and education at Allies for Health + Wellbeing. “It’s here again, it’s prominent, and it can be passed through skin contact with a sore. That’s something a lot of people don’t think a lot about.”
Syphilis can cause serious damage to your health and is most often contracted through contact with a syphilis sore during sex. Anyone who is sexually active can contract syphilis, and some behaviors can increase your risk of syphilis. Talk to your healthcare provider about how frequently you should be tested for syphilis.
Pregnant people can pass syphilis to their fetuses during pregnancy or suffer pregnancy complications, miscarriages or stillbirth. Congenital syphilis – when babies contract syphilis before birth (in-utero) – reached a record high in Pennsylvania in 2023, according to the Pennsylvania Department of Health. There were 29 reported cases of congenital syphilis in Pennsylvania outside of Philadelphia. Children with congenital syphilis can have serious health problems, including jaundice, bone and growth abnormalities, eye abnormalities, hearing loss, seizures and stroke.
Pregnant people should be tested at the beginning of their pregnancy and may need additional testing later in the pregnancy.
Even If you have been treated for syphilis, treatment does not protect you from contracting syphilis again in the future.
GONORRHEA AND CHLAMYDIA
These two common sexually transmitted infections often have no symptoms, but Branch offers advice on symptoms that can be associated with gonorrhea and chlamydia.
“Discharge, pain during urination are the most common ones,” Branch said, also noting that throat pain or a sore throat that won’t go away can also be symptoms. “In terms of the rectum, itchiness and discharge also.”
Dr. Sarah McBeth, medical director at Allies, says that there can be differences in symptoms based on sex organs as well.
“People who have a uterus, especially with chlamydia, don’t have symptoms that would take them to the doctor,” she said, though vaginal discharge or pelvic pain might occur. “In people with penises, it would often be discharge, burning with urination. They almost always have burning.”
There can also be symptoms that you might not associate with a sexually transmitted infection.
“Gonorrhea can cause rashes and joint infections, so painful swollen joints can happen with gonorrhea,” McBeth said.
The World Health Organization and other medical organizations recommend that most people get tested for gonorrhea and chlamydia on a yearly basis. If you have sex with multiple or anonymous sex partners, talk to your healthcare provider about whether you should be tested more frequently.
If you do have gonorrhea or chlamydia, the diseases are treatable with antibiotics. Allies offer both injectable and oral treatment options (for those adverse to needles).
“It’s strongly recommended that folks get an injection of the medication,” McBeth added. “If we give you a shot, we know you got treated.”
Condoms can help prevent the spread of gonorrhea and chlamydia, but they’re not foolproof. Also, if a person is on PrEP for HIV prevention, that medication does not protect against other STIs.
“That’s why it’s important to still get tested, period,” Branch said.
If you believe you’ve been exposed to syphilis, gonorrhea or chlamydia, doxy-PEP is also an option.
“Doxy-PEP is a medication taken after a high-risk sexual exposure, and it’s been shown to reduce rates of chlamydia and syphilis and to some extent, gonorrhea,” McBeth said.
RISK BEHAVIOURS
Anyone who has sex can contract an STI, though some behaviors can put you at greater risk for getting infected. According to the Mayo Clinic and the American Council of Obstetricians and Gynecologists (ACOG) these behaviors can include:
- Having a new sex partner
- Having sex without a condom
- Having multiple and/or anonymous sex partners
- Having a sex partner who has more than one sex partner
- Having a diagnosis of HIV or another sexually transmitted infection
- Exchanging sex for money or drugs
Talk to your healthcare provider about your sexual behaviors, STI testing and how frequently you should be tested. If you do contract syphilis, gonorrhea or chlamydia, you should notify your sex partners so they can be tested and prevent the spread of these infections.
Allies for Health + Wellbeing offers testing for syphilis, gonorrhea and chlamydia, as well as HIV and hepatitis C, in its East Liberty clinic as well as at partner organizations and events. Allies also provides doxy-PEP for exposure to syphilis, chlamydia and gonorrhea. Visit AlliesPGH.org or call 412-345-7456 to make a testing appointment. Find our free testing dates and locations at alliespgh.org/resources/free-testing
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