To talk about syphilis prevention, we first go over the different ways syphilis can be transmitted:
Data that explores the likelihood of transmission according to each risk behaviour is challenging to come by. It relies on a variety of factors, such as frequency of behaviour, type of behavior, stage of syphilis, condom usage, etc.
Syphilis is usually infectious for less than one year, during primary and secondary stages, and in the beginning of the latent stage. The symptomatic stages - primary and secondary - are the most contagious. Late latent syphilis (infection has lasted over one year) is considered to be non infectious.
Around 20-30% of those with syphilis at the latent stage have a relapse of the secondary stage of the infection. Relapses can occur several times, and when relapses no longer occur, a person is no longer contagious through contact (this does not apply to pregnancy and childbirth).
When the infection has lasted over one year (late latent syphilis), it is considered to be non infectious. Once symptomatic relapses cease, syphilis is usually no longer contagious through sexual contact.
All persons with active syphilis infection are contagious in the primary, secondary, and early latent phases.
Condoms (protecting the user)
Using latex or polyisoprene condoms and/or oral dams for all sexual activities, including oral sex. This type of prevention does not completely eliminate the chance of transmissions, as syphilis sores may be in uncovered regions, however consistent condom use reduces the risk.
Dental dams (protecting the user)
Although dental/oral dams do not fully prevent syphilis, their correct and consistent use can reduce your chance of getting the infection.
Pill and/or vaccination (protecting the user)
There are currently no approved pills or vaccines in Canada that can be taken to prevent syphilis before a possible exposure. The only ways to prevent syphilis is to ensure frequent STI testing, safer sex practices, and that syphilis treatment is equitably distributed when needed.
Testing & Treatment (protecting the user)
Talk to your partners about their history of STIs, and their latest STI test. If you or your partner notice any unusual discharge, a sore around the groin area or in the mouth, and/or a rash on the hands and feet , avoid having sex and speak to a health provider as soon as possible.
If you’re sexually active, pregnant, or share drug use equipment, it’s really important to ensure you’re getting tested for STIs. Getting tested frequently is one of the best tools we have to prevent transmissions.
While the tools to prevent contracting syphilis are the same as the tools that will prevent you from transmitting, it is important to ensure you are not sexually active when actively infected and for the 7 days following your treatment.
Since syphilis sores can be present in areas uncovered by oral dams and condoms, there’s still a possibility of transmission when condoms are used. Taking a combined approach to prevent syphilis through STI testing, condom use, etc. can maximize your ability to prevent syphilis.
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