Syphilis is a stupendous badass.
Nothing as successful as our dear old friend Treponema pallidum is going to just up and die out. It’s gonna mutate, it’s gonna evolve! So we’ve learned to recognize a painless ulcer around the genitals or the rash on palms and soles? Well, then it’ll show up as lesions that look like herpes or flat, shiny, patches on the tongue, or even as joint pain reminiscent of Lyme disease. And it’s gonna team up with our new friend HIV so that having either one increases your risk of getting the other. Take that, you silly penicillin-inventing primates!
So, because of all these factors, after nearly disappearing for 30 years, syphilis infection is on the rise.
As with the other bacterial STIs, the key to not catching syphilis is to use barriers for any genital contact. Yes, for that. And yes, for that too. Yes, dental dams and condoms for oral sex. Yes, gloves for fingering. And- despite the complete illogic of having to do it- pester your primary care provider to test you regularly.
You’re not going to get a doctor who graduated in the last ten years say, “huh, you know, that could be syphilis. Let’s test you for it.” In fact, large numbers of docs think it’s pretty well dead and gone. Oh, foolish, foolish vertebrates. What great strides we could be making in keeping STI rates low if more care providers followed my midwife’s advice and tested for everything, all the time instead of arguing with patients about whether or not they need testing. Come, on y’all: the tests are easy, generally inexpensive and pretty reliable. (Except for the blood test for HSV, which needs a whole post of its own.) Just test your patients and lets all get on with our lives, ok?
That way, we can keep being the most stupendous badasses on the block.