Good-looking, well-educated, and a health professional, 26-year-old Jonathan Allman thought he played safe when it came to sex. So it was with great shock and surprise that he received, following a routine blood screening, a call from his employer one day.
"What happened was I had to take a physical for a job, and part of that physical was a blood screening, an RPR," he recalls. "A few days later, one of the secretaries at work called and told me to call the doctor in employee health, who told me I had tested positive on a test which suggested I had syphilis. They did a further test and determined I did. I was really surprised because I'd only had like three sex partners the year before, and the most important, interesting thing about it, was that we were using condoms. I'd always been so careful, in the age of HIV, to not do anything that would cause the transmission of HIV, but somehow I managed to transmit syphilis anyway. Safe sex wasn't safe enough I guess."
WE'RE GETTING SCREWED HERE!
Syphilis is a Sexually Transmitted Disease caused by Treponema Pallidum, a rascally, spiral-shaped bacteria ( spirochaete ) which can corkscrew its way into the genitals, mouth, or rectum. And once you've got it, it can kill if left untreated. Unfortunately, not many gay men seem to know its signs or effects. Certainly Allman didn't, even though he was educated about HIV—which admittedly stole the limelight for a long, long time.
For 20 years syphilis rates were on a downswing, so much that Donna Kaminski of New York's Gay Men's Health Crisis reports that "in 1999 the [ Centers for Disease Control ] were projecting eradication of the disease within five years."
However, over the past two years, syphilis infection resulting from men-with-men sex has shot through the roof. Indeed, the bells really went off during the first three months of 2000, when 93 cases were reported in Los Angeles. LA's outbreak was swiftly dealt with via an expensive campaign—including highly visible billboards—and figures dropped. But other cities, including New York, Seattle, San Francisco, Chicago, Philadelphia, and San Antonio, have proven recent hot spots for gay male infection. And CDC studies show that many gay men remain ignorant regarding this screwy and deadly li'l bastard.
HOW TO KNOW
IF YOU'VE BEEN SCREWED ...
Syphilis occurs in four stages. During the first, the Primary Stage, a hard, painless chancre sore appears at the spirochaete's point of entry—usually the penis, vagina, mouth, or anus—anywhere from three weeks to three months after infection. Syphilis is very contagious during this stage as the bacteria congregate within the sore and leak. The risk of HIV transmission is increased 2-to-5 fold as well. If you're already HIV+ the sore will teem with HIV. And if HIV-, the sore provides a doorway for HIV to pass through. This sore will eventually heal on its own if left untreated within 1-5 weeks, ending the Primary Stage.
Anywhere from a few days to months later, the Secondary Stage begins. Usually marked by unusual, rust-colored rashes ( sometimes dubbed "nickles and dimes" for their size ) which can appear anywhere, but most commonly on the palms of hands and soles of feet, this is also a highly contagious time.
After these symptoms subside— again, often on their own—syphilis enters the Latent Stage, slowly destroying your internal organs from brain to heart to nervous system to arteries, over the course of up to several decades. Then syphilis enters its final—and most deadly—stage, Tertiary Syphilis, which can leave you blind, paralyzed, impotent, with a bum ticker, or dead.
However, syphilis isn't nicknamed the "great mimicker" for nothing. Ranging from headaches to vomiting to fever to fatigue to hair loss, often its symptoms can be misdiagnosed as other maladies—as Allman learned too well. "I had a chancre sore, a bump, but I had it on the inside of my rectum so it wasn't diagnosed as that," he recalls. "In fact, I'd gone to the doctor because I had really bad itching and pain down there just from where it's location was. But even my doctor didn't diagnose it at first. She knew I was gay and sexually active, so she was looking for a STDs but she didn't test me for syphilis—she tested me for herpes." Allman's secondary symptom was equally perplexing. "Horrible, horrible warts on the soles of my feet and the palms of my hands," he blanches. "At first I was thinking Compound W, but there were like 50 of them."
Worst of all, the symptoms may not appear at all or remain where you can't see them ( within the mouth or anus ) . But all is not lost, girls!
SCREWED NO MORE!
The good news is that syphilis is easily curable. Anywhere from one to three shots of penicillin administered by a doctor ( don't pop those leftover pills in the medicine cabinet from when you had a sore throat! ) will clear it up. And testing only requires a blood test. Do keep in mind that if you think you were infected in past years but have never been tested for syphilis, now is the time— the damage it causes in its latent stage to your organs is irreversible, even if the bacteria itself gets cleared up. For people who are HIV positive, it's particularly imperative to test as syphilis can run an accelerated course, doing its damage in no time at all. And pregnant women can pass syphilis to their fetus, which could result in retardation or stillbirth. That's truly getting screwed—even if you got kissed in the process.
STAYING SCREW-FREE
( WHILE STILL SCREWING )
Play safe, boys! Some of the increase in gay infections is due to current trends of lapsing when it comes to safe sex. Yes, HIV is still here as are plenty of its friends and relatives. Latex barriers are still the best protection against STDs. Condoms for screwing ( in the good way ) and oral sex, and a dental dam during rimming to prevent mouth-to-anus infection ( which might have saved Allman from his being infected ) . Do have fun but just remember there's more than one party pooper out there.
"I suppose it was a bit of a wakeup call about how save I was being sexually," Allman sighs. "I don't really think the average gay person has any sense there are other diseases they can get that are just as dangerous if they're not caught and treated."
Call your physician or Howard Brown Health Center for testing or more information, ( 773 ) 388-1600.
