Alarm over high global rate of syphilis among MSM

The World Health Organization (WHO) is concerned about the “unacceptably high” rate of syphilis among men who have sex with men (MSM) around the world.

A first of its kind study has found that the prevalence of syphilis among MSM is 15 times higher than men in the general population.

Led by the London School of Hygiene & Tropical Medicine (LSHTM), in partnership with the WHO and Avenir Health, the research was published The Lancet Global Health.

The study – which reviewed data from 275 studies involving more than 600,000 participants in 77 countries – concluded that the worldwide prevalence of syphilis among MSM is 7.5% compared to 0.5% for men in the general population.

Latin America and the Caribbean region had the highest prevalence of syphilis (10.6%), whereas Australia and New Zealand had the lowest (1.9%).

Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum. When diagnosed, syphilis is easily treated with penicillin. One study found that annual screening and treatment of at least 62% of sexually active MSM is necessary to achieve local elimination.

“Men tend to be disadvantaged when it comes to syphilis testing and treatment,” said Dr Matthew Chico, Associate Professor at LSHTM and lead author. “Women are routinely screened for syphilis at their first antenatal care visit, and are offered testing at family planning services. Men in general do not have the same number of contacts with the health system as women, and MSM face additional barriers due to stigma and shaming.

“As diseases go, syphilis is terribly deceptive. In the primary and secondary stages of infection, skin lesions, such as chancre or rash, may present, only to then disappear as if the person has been cured. Unfortunately, without treatment, the bacterium will slowly invade internal organs, and can lead to physical deformity, loss of vision, dementia, and even death. There is no good reason for this to happen. We have effective treatment.”

Eloise Stonborough, Associate Director of Policy and Research at Stonewall said: “It’s important that everyone, including LGBTQ+ people and those at higher risk, is supported to understand how to protect themselves against syphilis and other sexually transmitted infections.”

She added: “It’s also vital that healthcare services are inclusive and welcoming of all lesbian, gay, bi, trans and queer people, so everyone feels comfortable getting the help and support they need.”

Protection against syphilis

Using condoms and dental dams during vaginal, anal and oral sex offers the best protection against contracting or passing on syphilis.

Syphilis symptoms

Syphilis usually causes a painless ulcer, usually in the genital area. The ulcer will disappear on its own, but other symptoms may appear, such as a rash on the body and swollen glands. In its early stages, syphilis is very infectious and can be passed on by close skin contact during sex. If it’s left untreated for years, it can spread to the brain or other parts of the body and cause serious, long-term problems.


Treatment for syphilis is with antibiotics. If you are concerned you may have syphilis, EMH will assess your risk and possible symptoms. If required, this will be followed by a blood test and antibiotic treatment. Call or WhatsApp Engage Men’s Health on 082 607 1686 for these free services in Johannesburg, Nelson Mandela Bay and Buffalo City.