What is the primary mode of syphilis transmission?

From the Guidelines

Syphilis is primarily transmitted through direct sexual contact with an infected person, emphasizing the need for routine discussion of sexual behaviors and client-centered risk reduction messages to prevent its spread. The primary mode of syphilis transmission is through sexual contact, where the bacterium Treponema pallidum enters the body through mucous membranes or breaks in the skin during vaginal, anal, or oral sex with someone who has an active infection 1. This underscores the importance of primary prevention of syphilis among high-risk groups, such as persons with HIV infection, through routine serologic screening and intensified counseling messages. Key factors that increase the risk of transmission include having multiple partners, unprotected intercourse, and engaging in sex in conjunction with illicit drug use or methamphetamine use 1.

Transmission Modes and Prevention

• Syphilis can be transmitted from a pregnant woman to her unborn child, resulting in congenital syphilis.
• The disease is most contagious during the primary and secondary stages when visible sores (chancres) or rashes are present.
• Transmission can occur at any stage of the infection if there is direct contact with infectious lesions.
• Using barrier methods like condoms during sexual activity can significantly reduce the risk of transmission, though they don't provide complete protection if sores are present in areas not covered by the condom.
• Early detection and treatment with antibiotics, such as penicillin G benzathine, can cure the infection and prevent transmission to others.

Key Considerations for Prevention

• Routine serologic screening for syphilis is recommended at least annually for all sexually active HIV-infected persons, with more frequent screening for those with high-risk behaviors 1.
• Persons undergoing screening or treatment for syphilis should also be evaluated for all common sexually transmitted diseases (STDs) 1.
• The occurrence of syphilis in an HIV-infected person is an indication of high-risk behavior and should prompt intensified counseling messages and strong consideration of referral for behavioral intervention 1.

From the Research

Syphilis Transmission

• Syphilis is a sexually transmitted disease that can be spread through direct contact with the inoculation point of the spirochete 2.
• The primary mode of syphilis transmission is through sexual activity, including vaginal, anal, and oral sex 3, 2.
• Syphilis can also be transmitted from a mother to her child during pregnancy, resulting in congenital syphilis 4.
• The disease can cause severe illness, miscarriage, stillbirth, and early infant death if left untreated 4.

Modes of Transmission

• Syphilis can be transmitted through:
  • Sexual contact with an infected person 3, 2.
  • Mother-to-child transmission during pregnancy 4.
  • Blood transfusion (although rare) 3.
• The risk of transmission is higher in men who have sex with men 2.

Prevention and Treatment

• Early detection and treatment of syphilis can prevent long-term complications and reduce the risk of transmission 3, 5, 6.
• Antibiotics, such as penicillin, doxycycline, and azithromycin, are effective in treating syphilis 3, 5, 6.
• Regular screening and testing for syphilis are essential for preventing and controlling the spread of the disease 4.