Marcus Y Chen
Syphilis, which had been uncommon in Australian cities until
recently, has re-emerged as a major sexually transmissible
infection among men who have sex with men.
In this article we review the clinical features and management
of syphilis infection, together with measures clinicians can
undertake to enhance syphilis control.
Syphilis should be considered in men who have sex with men
who present with a rash or anogenital lesions. Men who have
sex with men should be serologically screened for syphilis
on a regular basis, including those who are HIV infected.
Management of syphilis infected individuals should include
adequate treatment and efforts to maximise the testing and
treatment of sexual partners. Early detection and treatment
of syphilis will help control the current syphilis epidemic in
Australia among men who have sex with men.
Syphilis is a sexually transmissible infection (STI) caused by the spirochete Treponema pallidum. In recent years, syphilis has re-emerged among men who have sex with men (MSM) in a number of industrialised countries, including Australia, where a substantial proportion of cases have occurred in human immunodeficiency virus (HIV) infected MSM. This has occurred on a backdrop of an increase in HIV notifications and high rates of bacterial STIs such as chlamydia and gonorrhoea among MSM in Australia.1–4 While it is less common among heterosexuals in urban Australia, syphilis remains endemic among some remote indigenous communities and is seen in individuals who have engaged in unprotected sex while overseas.
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