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Syphilis is a bacterial sexually transmitted infection (STI) usually spread through vaginal, anal, or oral sex and/or skin-to-skin contact. Syphilis causes painless sores (called a chancre) that can easily spread the infection to other people. Syphilis is passed from person to person through direct contact with a syphilis sore. Syphilis can infect your vagina, anus, penis, scrotum, and sometimes your lips and mouth. 

Syphilis infection can be active at times and inactive at other times. Symptoms can be easily missed in either situation. This makes it easy to pass it on to someone else without realising. The best way to know your status is to test regularly. 

There are three main stages of syphilis infection: primary, secondary and tertiary. Syphilis can be easily cured with medication if you treat it early. Without treatment, it can get worse over time and cause serious health problems.

Signs and Symptoms

Content warning: click to show images of symptoms

Each stage of syphilis has different symptoms but is very commonly asymptomatic, so it’s important to test regularly.

PRIMARY – ‘Stage One Syphilis’ 

SECONDARY – ‘Stage Two Syphilis’

Latent stage syphilis

TERTIARY – ‘Late Latent Stage Syphilis’


Syphilis is usually spread through skin-to-skin contact during vaginal, anal or oral sex with a person in the first 2 stages of the infection. It can also be spread by direct contact with open sores on areas such as the lips, mouth, breasts or genitals. People with tertiary syphilis are not usually infectious. 

Syphilis is highly contagious when a sore or rash is present but can also be passed on when a person has no symptoms. Syphilis can occasionally be spread by blood contamination, needle-stick injury, or sharing injecting equipment.

Pregnant people with syphilis can pass the infection to their baby during pregnancy or birth. 

Syphilis can be transmitted via 

  • Any sexual activity that means your genitals, anal area, or mouth come into contact with the bacteria that causes syphilis
  • Rubbing, nudging and other forms of skin-to-skin contact that involves the genitals, anal area and/or mouth
  • Unprotected vaginal or anal sex
  • Covered/protected vaginal or anal sex, if the skin touches an area that has syphilis
  • Condomless oral sex
  • Covered/protected oral sex, if the mouth touches an infected area
  • Touching syphilis sore with your fingers then touching a mucous membrane (such as your eyes, inside of your nose or mouth, or your genitals)
  • Sharing sex toys
  • It is also passed on during pregnancy and birth

Sharing saliva without direct contact with a syphilis symptom inside another person’s mouth is considered low-risk.

You cannot get syphilis from sharing food or drinks, hugging, holding hands, coughing, sneezing, sharing towels, or sitting on toilet seats.

Blood-to-blood contact

While very rare, syphilis transmission can happen due to blood-to-blood contact. 

Blood transmission of syphilis can occur when sharing injecting equipment or if blood comes into contact with an open or bleeding wound like an ulcer or bleeding gums. There are very few cases of people contracting syphilis through blood-to-blood contact.


As syphilis can be asymptomatic, regular sexual health screening is highly recommended. You can view a list of sex worker-friendly sexual health clinics on our Where To Test page.

Additional ways to prevent syphilis transmission include:

  • Check clients for visible STI symptoms before the booking goes ahead. Use light and gloves if possible.
  • Wash your hands after the check if you don’t use gloves.
  • Use condoms and dams during genital contact – remember that symptoms are usually not noticeable. 
  • Use condoms and/or dams for oral sex/rimming, and check for syphilis symptoms outside the area covered by a condom or dam.
  • Cover toys with condoms, and wash and re-cover before using on yourself.
  • Put a bandaid on anything that looks like a symptom of primary syphilis.
  • Cover symptoms of primary syphilis with a towel.
  • Reconsider deep kissing.
  • Do face-down body rubs and body slides to avoid genital contact with symptoms of primary syphilis.
  • Reduce contact between genitals.
  • Always use fresh, sterile syringes and injecting equipment and dispose of them safely. You can use this website to find your nearest Needle Syringe Program (NSP).

It is recommended that you always change condoms when going from anal to vaginal or oral sex.


Here’s some information about testing for syphilis. You can view a list of sex worker-friendly sexual health clinics on our Where To Test page.

Testing method

When to Test

Other Info


Syphilis is treatable and best treated early. Here’s what you need to know about treating it.   

Testing Method

Costs and other information 

How might this impact my work? 

Practical Considerations

  • It is recommended that you do not have sex for 7 days after you finish treatment. 
  • If you can’t avoid having sex, then using a condom will help lower the chance of transmitting syphilis, but there is no guarantee, as the condom only protects the skin that it covers. 
  • Some antibiotics can reduce the effectiveness of oral contraception (‘the pill’). 
  • If you often get thrush when taking antibiotics, you may want to take probiotics during and after treatment to help prevent this.
  • You should inform any recent doubles partners if you test positive for syphilis. 

Legal and Reporting Considerations

  • Some states and territories may have laws that criminalise sex working or having sexual contact while you have a BBV or STI. Check out our BBV, STI and the Law resource or contact your local sex worker peer organisation for more information. 
  • Contact tracing of previous sexual partners (known as ‘partner notification’) is a consideration for some BBV and STI. It should be done with consideration of the unique transmission risk and privacy needs of sex workers. Your local sex worker peer organisation can advise on any partner notification process to ensure it is appropriate for your circumstances. 
  • Syphilis is a nationally notifiable disease in Australia, meaning diagnosed cases of syphilis are anonymously reported to state or territory health departments.

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