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What is Capacity Building Assistance (CBA)?
Capacity Building Assistance (CBA) focuses on maintaining and increasing
the infrastructural systems and resources necessary to support interventions,
and enhance the abilities of key personnel to plan and implement
interventions and activities. Capacity building focuses on the development
of core competencies, or skills of individuals in both organizations
and communities to more effectively deliver HIV prevention services,
and to sustain and support infrastructure for HIV programs.
What is MPIC~APIN?
The Midwestern Prevention Intervention Center of the African American
Prevention Intervention Network (MPIC~APIN) is a project designed
to assist community based organizations (CBOs) in the Midwestern
Region of the United states with adaptation, implementation, quality
assurance and evaluation of effective HIV prevention interventions.
The geographic region serviced by MPIC~APIN is: CO, IA, KS, MO,
MT, NE, S. Dakota, N. Dakota, UT and WY.
How can Capacity Building Assistance help you to better serve your community?
- Through jointly developing a comprehensive capacity building
assistance needs assessment that reflects your prioritized needs.
- Through stronger community based organizations representative of
African Americans in science based prevention efforts against HIV
disease.
- Through behavioral science and intervention effectiveness that
are essential elements in building the capacity of organizations
to lead the fight against HIV disease.
How Do You Access CBA Services?
- Contact your CDC Project Officer.
- Your CDC Project Officer will deliver your request to the CBA Coordinator.
- The CBA Coordinator will assign your request to the appropriate
provider(s).
- A CBA provider will contact your organization directly to assess
your needs.
- Community stakeholders, indirectly or non-CDC funded health departments
and community based organizations should contact the MPIC Coordinator,
E. Tyronne Howze at (314) 421-9600 or by e-mail at ET Howze@aol.com
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Diffusion of Effective Behavioral Interventions (DEBI)for HIV Prevention
The Diffusion of Effective Behavioral Interventions
Project (DEBI) is a national-level strategy to provide high quality training and on-going technical assistance on selected evidence-based HIV/STD prevention interventions to state and community HIV/STD program staff.
The interventions have been proven effective through
research studies that showed positive behavioral (e.g.,
use of condoms; reduction in number of partners) and/or
health outcomes (e.g., reduction in the number of new
STD infections). Studies employed rigorous research
designs, with both intervention and control groups,
so that the positive outcomes could be attributed to
the interventions. With input from the researchers,
the materials necessary to implement the interventions
have been packaged into user-friendly kits. With the
appropriate training and intervention package, service
providers can increase their opportunities to conduct
effective HIV/STD prevention programs in their communities.
Why Community and Group-Level interventions?
Community- and group-level interventions, compared to
individual-level, have the potential to reach large numbers
of the population and reach individuals at high risk
who might not voluntarily seek prevention information
or services. They are also more cost-effective.
The interventions in the Compendium have been identified
by CDC's HIV/AIDS Prevention Research Synthesis Project
(PRS) as having used rigorous study methods and demonstrated
evidence of effectiveness in reducing sex- and drug-related
risk behaviors and/or improving health outcomes.
Overview of DEBI Interventions
Healthy Relationships
Healthy Relationships is a five-session, small-group
intervention for men and women living with HIV/AIDS.
It is based on Social Cognitive Theory and focuses
on developing skills and building self-efficacy and
positive expectations about new behaviors through
modeling behaviors and practicing new skills. Decision-making
and problem-solving skills are developed to enable
participants to make informed and safe decisions
about disclosure and behavior. The sessions create
a context where people can interact, examine their
risks, develop skills to reduce their risks, and
receive feedback from others.
Holistic Harm Reduction Program (HHRP)
The Holistic Harm Reduction Program (HHRP) is a 12-session,
manual-guided, group level program to reduce harm,
promote health, and improve quality of life. The
primary goal of HHRP is to provide group members
with the resources (i.e., knowledge, motivation,
and skills) they need to make choices that reduce
harm to themselves and others.
Many Men, Many Voices
Many Men, Many Voices (3MV) is a six- or seven-session,
group level STD/HIV prevention intervention for gay
men of color. The intervention addresses behavioral
influencing factors specific to gay men of color,
including cultural/social norms, sexual relationship
dynamics, and the social influences of racism and
homophobia.
Mpowerment
This community-level intervention for young men who
have sex with men uses a combination of informal
and formal outreach, discussion groups, creation
of safe spaces, social opportunities, and social
marketing to reach a broad range of young gay men
with HIV prevention, safer sex, and risk reduction
messages.
Popular Opinion Leader (POL)
This 4 session community-level intervention involves
identifying, enlisting, and training key opinion
leaders to encourage safer sexual norms and behaviors
within their social networks through risk-reduction
conversations.
Community PROMISE (Peers Reaching Out and Modeling
Intervention Strategies)
This community-level intervention is based on several
behavior change theories. A community assessment process
is conducted, peer advocates are recruited and trained
from the target population, role model stories are
written from interviews with the target population,
and these stories are distributed along with other
risk reduction materials to target audiences to help
people move toward safer sex or risk reduction practices.
The intervention can be adapted for various population
groups (IDUs, MSM, sex workers, Native Americans, and
youth at high risk).
Real AIDS Prevention Project (RAPP)
A community mobilization program, designed to reduce
risk for HIV and unintended pregnancy among women
in communities at high risk by increasing condom
use. This intervention relies on peer-led activities,
including: outreach/one-on-one brief conversations
with brochures, referrals, and condom distribution;
small group safer sex discussions and presentations.
There is also peer interaction with community businesses
that participate in media campaigns with distribution
of role model stories and prevention and health information
newsletters and brochures. RAPP is based on the transtheoretical
model of behavior change.
SISTA (Sisters Informing Sisters About Topics on AIDS)
This group-level, gender- and culturally- relevant
intervention is designed to increase condom use with
African American women. Five peer-led group sessions
are conducted that focus on ethnic and gender pride,
HIV knowledge, and skills training around sexual risk
reduction behaviors and decision making. The intervention
is based on Social Learning theory as well as the theory
of Gender and Power.
Street Smart
A multi-session, skills-building program to help runaway
and homeless youth practice safer sexual behaviors
and reduce substance use. Sessions address improving
youths' social skills, assertiveness and coping through
exercises on problem solving, identifying triggers,
and reducing harmful behaviors. Agency staff also
provide individual counseling and trips to community
health providers.
Teens Linked to Care (TLC)
TLC is an effective intervention for young people living
with HIV. TLC is delivered in small groups using
cognitive-behavioral strategies to change behavior.
Young people meet regularly to provide social support,
learn and practice new skills, and socialize. This
program helps young people identify ways to improve
the quality of their lives by setting new habits
and daily social routines. They set goals regarding
their health, sexual relationships, drug use, and
daily peace.
VOICES/VOCES (Video Opportunities for Innovative
Condom Education & Safer Sex)
A group-level, single-session video-based intervention
designed to increase condom use among heterosexual
African American and Latino men and women who visit
STD clinics. Participants, grouped by gender and ethnicity,
view an English or Spanish video on HIV risk behaviors
and condom use and take part in a facilitated discussion.
Safety Counts
Safety Counts is an HIV prevention intervention for
active injection drug and crack cocaine users aimed
at reducing both high-risk drug use and sexual behaviors.
It is a behaviorally focused, seven-session intervention,
which includes both structured and unstructured psycho-educational
activities in-group and individual settings.
Fundamentals of HIV Prevention Counseling
This course is designed to develop a counselor’s
proficiency and enhance the abilities of counselors
in HIV testing contexts as well as other settings to
provide effective HIV prevention counseling.
HIV Prevention Counseling: Addressing Issues of Clients
Who Test Positive
This course is designed to give voice to the considerable
challenges involved in counseling clients who receive
a diagnosis of a highly stigmatized and life-threatening
disease that is epidemic. There is a brief review of
counseling, behavior change principles and strategies
for taking action and a discussion of the often competing
expectations placed on this work helps to define some
reasonable parameters of effective counseling of HIV-positive
clients.
Partner Counseling and Referral Services (PCRS)
This course id designed to enhance a counselor’s
ability to: a) provide services to HIV-infected persons
and their sex and needle-sharing partners so they can
reduce their risk for infection or, if already infected,
can prevent transmission to others and b) help partners
gain earlier access to individualized counseling, HIV
testing, medical evaluation, treatment, and other prevention
and support services.
Go to http://www.effectiveinterventions.org for more
information on the DEBI Project.
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What is HIV and why do I need to know about it?
AIDS - acquired Immunodeficiency syndrome - is caused by a virus called
HIV, the human immunodeficiency virus.
AIDS was first seen in the United States in 1981 and is now a major
problem all over the world. We have all heard much about AIDS in the
news over the years, and the number of deaths it has caused worldwide,
particularly in areas hardest hit by the disease like Africa. Many
myths have been spread about AIDS and it is important for every person
to know the facts about HIV and AIDS.
HIV attacks, kills, and damages the cells in the body's immune system.
Our immune system protects our bodies from disease and infection. Over
time, HIV weakens a person's immune system, making it hard to fight
off infections and certain cancers. People who have AIDS can get very
sick with infections that most healthy people can fight off. These
are called opportunistic infections (OIs), and can be life threatening.
There is no cure for AIDS and while treatments may help some people
manage their disease, AIDS is still fatal.
Almost one million Americans are living with HIV infection, one-third
of who do not even know that they have HIV. HIV has hit African American
and Hispanic women the hardest. While they make up less than 25 percent
of the people in the U.S., they account for more than 77 percent of
AIDS cases in women.
How does a person become infected with HIV? Is it true that a pregnant
or breastfeeding woman can give HIV to her baby?
HIV is found in body fluids - blood, semen (the fluid a man releases
from his penis when he becomes sexually aroused or has an orgasm),
vaginal fluid (fluid or secretions from a woman's vagina or birth canal),
and breast milk.
HIV can enter the body:
- By having unprotected (meaning not using a condom) vaginal, anal,
or oral sex with a person living with HIV. HIV can enter the body
through the lining of the vagina (birth canal), vulva ("lips" or
opening to the vagina), penis, rectum, or mouth during sex. Anal
sex without a condom is very risky because the rectum does not stretch
easily (like the vagina), making it more likely to tear and bleed,
and making it easier to become infected with HIV.
- By sharing needles, syringes, and other drug injection equipment
that has a small amount of blood on it from someone who has HIV.
This refers to both equipment used to inject illegal drugs (like
heroin and cocaine) and legal drugs (like steroids, insulin, and
vitamins). A person can also get HIV from using tattoo or body piercing
equipment and razors that have blood on them from someone who has
HIV.
- During pregnancy, birth, or breastfeeding from a mother who has
HIV to her baby. During pregnancy, HIV can be passed to the growing
fetus through the placenta. HIV can also be passed to the baby during
the birth process and through breast milk during breastfeeding. Women
who have HIV should not breastfeed their babies. An option for a
mother who has HIV could be donor milk from a milk bank or infant
formula. Call the Mother's Milk Bank, at (919) 350-8599 for help.
About 25 to 33 percent of all pregnant women who don't take the drug
zidovudine (AZT) during pregnancy will pass HIV to their babies.
Taking AZT while pregnant and having a cesarean, or C-section, delivery
drops a woman's chances of passing HIV to her baby to 1 percent.
- Through contact with infected blood. Before donated blood was tested
for HIV and before heat-treating techniques to kill HIV in blood
products were introduced, a person could get HIV from transfusions
of HIV infected blood or blood products. Today in the U.S., because
all blood is screened for HIV, the risk of getting HIV from blood
transfusions is very small. But, some countries don't test donated
blood for HIV.
Can you get HIV from doing things like kissing?
HIV has been found in the saliva of people who have HIV. But,
it has never been proven that HIV is spread by contact with saliva, such
as with kissing. Researchers have also found no proof that HIV is spread
through sweat, tears, urine, or feces.
There have been many studies of families of people who have HIV. All
have shown very clearly that HIV is not spread through casual contact,
such as sharing eating utensils, towels and bedding, swimming pools,
telephones, or toilet seats. HIV is not spread by biting insects such
as mosquitoes, fleas, or bedbugs.
What are the signs of HIV infection? Do women and men have the same symptoms?
Many people have no symptoms when they
first become infected with HIV. But some people
get a flu-like illness within a month or two
after being exposed to the virus. The flu-like
symptoms - fever, headache, fatigue, swollen
lymph nodes (immune system glands in the neck
and groin) - often go away within a week. During
this time, HIV is present in large amounts in
semen and vaginal fluids and it is very easy
to pass the infection to another person.
All people who have HIV go through what is
called an asymptomatic period of infection.
This means that a person lives symptom free
for a period of time. But, during this time
they can still pass the infection to another
person. The asymptomatic period varies greatly
from person to person. Some people may begin
to have symptoms within a few months, while
others may be symptom free for 10 years or
more.
HIV is active inside a person's body, even
when no symptoms are present. The virus multiplies,
or makes more virus, killing more and more
cells of the immune system that fight infection
(called CD4 and T cells). This process weakens
a person's immune system over time. For many
people, the first symptom they notice is large
lymph nodes (swollen glands) that may be enlarged
for more than 3 months. Other symptoms often
felt months to years before the onset of AIDS
include:
- Lack of energy or fatigue
- Weight loss.
- Frequent low-grade fevers and night sweats.
- Frequent yeast infections (in the mouth).
.
- Skin rashes or flaky skin that is hard
to get rid of.
- Short-term memory loss.
Women who have HIV can also have other symptoms
that happen more often, may not respond to treatment,
and can be harder to cure including:
- Vaginal yeast infections.
- Other vaginal infections such as bacterial
vaginosis and common STDs like gonorrhea,
chlamydia, and trichomoniasis.
- Human papillomavirus (HPV) infections that
cause genital warts and can lead to cervical
cancer.
- Pelvic Inflammatory disease (PID), or infection
of a woman's reproductive organs.
- Menstrual cycle changes, such as not having
periods.
What is AIDS?
AIDS refers to the most advanced stages
of HIV infection. The Centers for Disease Control
and Prevention defines AIDS as being infected
with HIV and having fewer than 200 CD4 and T
cells per cubic millimeter of blood. (Healthy
adults have CD4 and T cell counts of 1,000 or
more). AIDS also includes 26 different conditions,
some of which are called opportunistic infections
(OIs), or infections that don't usually make
a healthy person sick. People who have AIDS can
have severe OIs, which can be fatal because their
bodies can't fight off certain bacteria, viruses,
and other microbes. People with AIDS are also
more likely to develop cancers, such as Kaposi's
sarcoma, cancer of the cervix (opening to the
uterus or womb), and lymphomas (cancers of the
immune system).
Symptoms of OIs common in people with AIDS include:
- Coughing and shortness of breath.
- Seizures and lack of coordination.
- Difficult or painful swallowing.
- Mental symptoms such as confusion and forgetfulness.
- Severe and persistent diarrhea.
- Fever.
- Loss of vision.
- Nausea, abdominal cramps, and vomiting.
- Weight loss and extreme fatigue.
- Severe headaches. Coma.
Is there a test for HIV?
Health care providers can tell if you have HIV by testing your blood
to see if you have antibodies (disease-fighting agents) to HIV in your
blood. You can't tell if you have HIV antibodies in your blood until
1 to 3 months AFTER you become infected. And, some people can take as
long as 6 months to develop antibodies to HIV in their blood. If you
think you have been exposed to HIV, it is best to get tested as soon
as possible. But, keep in mind that you may have to get another test
or have your test repeated in 6 months, to be sure that you have accurate
results.
Talk to your health care provider about testing and be sure to have
counseling before and after you are tested. Counseling will help you
to get the treatment you need if you are HIV positive and will help
you to learn how to not pass the infection to others. If you are HIV
negative, counseling will help you to stay negative by teaching you
what you can do to protect yourself.
The test used for HIV is called an ELISA test. If the ELISA test is
positive, it is always followed with a second test to confirm the result.
This is called a Western Blot test.
How is HIV infection treated?
In 1981, when AIDS was first seen in the U.S., there were no medicines
to fight HIV and few treatments for the opportunistic infections (OIs)
and cancers that happen when a person has AIDS. But over the past 20
years, researchers have developed drugs to fight both HIV infection
and AIDS OIs and cancers. There is no cure for AIDS and when a person
becomes infected with HIV, they will need life long treatment.
The Food and Drug Administration has approved several types of drugs
for treating HIV infection. A main goal of treatment is to stop the
virus from replicating, or making copies of itself. When the virus
is allowed to copy itself, it increases its numbers in a person's body,
weakening the immune system. Over time, a person is no longer able
to fight off infection and becomes sick.
One group of drugs stops the virus from replicating at an early stage
in its life cycle. These drugs are called nucleoside reverse transcriptase,
or RT inhibitors. RT inhibitors include zidovudine (AZT), zalcitabine
(ddC), dideoxyinosine (ddI), stavudine (d4T) and lamivudine (3TC).
These drugs may slow the spread of HIV in the body and delay the onset
of OIs.
A second, and more recent, group of drugs are called protease inhibitors.
They stop the virus from making copies of itself at a later stage in
its life cycle. These drugs include ritonavir (Norvir), saquinivir
(Invirase), indinavir (Crixivan), amprevnivir (Agenerase), nelfinavir
(Viracept), and Iopinavir (Kaletra).
One challenge to treating HIV infection is persons with HIV can build
resistance to these drugs. (Resistance means that the drugs stop working.)
Health care providers must use several of these drugs at the same time,
called a combination treatment, to stop the virus from replicating.
Another challenge is the side effects caused by drug treatment. Side
effects can vary widely from person to person. Some people can have
severe side effects, including death, and may have to stop or change
treatments.
One type of treatment, called highly active antiretroviral therapy,
or HAART, has greatly improved the health of many people with AIDS.
It can lower the amount of virus in a person's blood to levels so low
that it is hard to detect with a blood test. This can mean relief from
symptoms and OIs, increasing the quality of life for a person living
with AIDS. There are also treatments for OIs and cancers.
What can I do to keep myself from getting HIV?
There is no cure or vaccine for HIV infection and AIDS. It is a life
long condition that requires life long treatment. That's why it's so
important to keep from getting it in the first place. Here are ways to
keep from getting HIV:
- The best way to prevent HIV or any STD is to practice abstinence
(don't have sex). Delaying having sex for the first time is another
way to reduce your chances of getting an STD. Studies show that the
younger people are when having sex for the first time, the more likely
it is that they will get an STD. The risk of getting an STD also
becomes greater over time, as the number of a person's sex partners
increases.
- Have a sexual relationship with one partner who doesn't have any
STDs, where you are faithful to each other (meaning that you only
have sex with each other and no one else).
- Practice "safer sex." This means protecting yourself with a condom
EVERY time you have vaginal, anal, or oral sex. For vaginal sex,
use a latex male condom or a female polyurethane condom. For anal
sex, use a latex male condom. If needed, use only water based lubricants
with male and female condoms. For oral sex, use a dental dam - a
device used by dentists, made out of a rubbery material, that you
place over the opening to the vagina before having oral sex. If you
don't have a dental dam, you can cut an unlubricated male condom
open and place it over the opening to the vagina. Even though it
may be embarrassing, if you don't know how to use a male or female
condom, talk to your health care provider. The biggest reason condoms
don't work is because they are not used correctly.
- Be aware that condoms don't provide complete protection against
STDs. But, they do decrease your chances of getting an STD. Know
also that other methods of birth control, like birth control pills,
shots, implants, or diaphragms don't protect you from STDs. If you
use one of these methods, be sure to also use a condom every time
you have sex.
- Limit your number of sexual partners. Your risk of getting HIV
increases with the number of partners you have.
- Don't douche. Douching removes some of the normal bacteria in the
vagina that protects you from infection. This can increase your risk
for getting HIV.
- Learn how to talk with your partner about STDs and using condoms.
It's up to you to make sure you are protected. The organizations
in the "For more information" at the end of this FAQ have tips for
talking with your partner. You can also talk with your health care
provider about this.
- When you are sexually active, especially if you have more than
one partner, get regular exams for STDs from a health care provider.
Tests for STDs can be done during an exam. And, the earlier an STD
is found, the easier it is to treat.
- Learn the common symptoms of HIV and other STDs. Seek medical help
right away if you think you may have HIV or another STD.
- If you are HIV positive and pregnant, you can lower the chances
of giving HIV to your baby by taking AZT during pregnancy, labor,
and delivery and having your baby take AZT for the first 6 weeks
of life.
- Remember that HIV is a life long disease. When you have HIV, you
may have periods of time with no symptoms. But, you can still pass
the virus to another person. If you have HIV, you need to tell your
sexual partners, so they can be tested
What is the latest research on HIV and AIDS?
The National Institutes of Health conducts research on HIV, which
includes testing HIV vaccines and new drug treatments and looking
at how HIV damages the immune system. Researchers are testing creams,
gels, and films (called microbicides) that can be used in the vagina
and rectum during sex to prevent HIV infection. They are also looking
at the role STDs play in HIV infection, how to help people change
their behaviors to keep from getting HIV, and ways for pregnant women
to prevent passing HIV to their babies. Women are taking part in
AIDS clinical trials across the country. Studies are looking at the
signs of HIV infection and AIDS in women and how HIV is passed to
babies.
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What is syphilis?
Capacity Building Assistance (CBA) focuses on maintaining
and increasing the infrastructural systems and resources
necessary to support interventions, and enhance the
abilities of key personnel to plan and implement interventions
and activities. Capacity building focuses on the development
of core competencies, or skills of individuals in both
organizations and communities to more effectively deliver
HIV prevention services, and to sustain and support
infrastructure for HIV programs.
- Syphilis is a curable infection caused
by the bacteria Treponema pallidum
- The bacteria enter the body through mucous membranes or abraded skin.
- Once inside the body, syphilis enters the blood stream and attaches to cells, damaging organs over time.
- There are four stages through which untreated syphilis progresses, each stage with its own unique signs and symptoms:
- 1. primary
- 2. secondary
- 3. latent
- 4. tertiary (or late)
How common is it?
- Up until 2000, the reported rate of syphilis in the United States was at its lowest level since reporting began in 1941. In 2001, the number of cases reported increased slightly by a little over 2%.
- This increase occurred only among men, while the number of cases continued to decline among women and among African American blacks.
- Most of the reported syphilis cases are in the Southeast of the country, with a higher percentage of cases among African-Americans than whites. In 2001, the South had the highest rate of syphilis, accounting for 56% of reported cases in the US.
- While rates appear to be improving, syphilis continues to disproportionately affect African Americans, with reported rates 16 times higher for African Americans than for white Americans.
- Syphilis rates usually increase and decrease in seven-to-ten year cycles, which maybe one reason for the increase.
How can I get syphilis?
Sexual
- Syphilis transmission can occur when infected lesions come in contact with the soft skin of the mucous membrane found inside the vagina, urethra or with an abrasion during vaginal, oral and anal sex, even if there is no sexual penetration.
- It is most easily spread during the first stage because symptoms usually go unnoticed.
- Syphilis can also be contracted from exposure to lesions or syphilitic "warts" during the secondary stage.
- If "warts" are present, they may easily spread the syphilis bacteria, due to the large amount of virus present.
- Because symptoms of secondary syphilis can recur, a person who has entered the latency stage of syphilis can still transmit the disease.
Nonsexual
- Because syphilis bacteria are extremely fragile, they cannot be spread during contact with objects such as toilet seats or towels.
- People, especially health care workers, can be at risk for syphilis if an abrasion or cut on the skin comes into contact with a syphilitic lesion
Mother-to-Child
- Syphilis can also be transmitted during pregnancy or during childbirth from a mother to her infant.
What are the symptoms of syphilis?
Primary Syphilis:
-Chancre
- The primary stage of syphilis is usually marked by the appearance of a single sore, known as a chancre, within 10 to 90 days after contact with the bacteria at the site of infection.
- It is usually appears as a single, painless sore, that is raised or elevated.
- Chancres may be found:
- outside the genitals, including the penis, scrotum and vagina
- inside the vagina or rectum
- at or around the anus
- on the lips or in the mouth, though this is not as common.
- The sore can last from one to five weeks and will go away by itself.
- The chancre will go away with or without treatment. Without treatment, the person will still have syphilis and can transmit it to others.
Secondary Syphilis
- The secondary stage of syphilis can develop 17 days to 6 1/2 months after infection.
- Symptoms can last from 2 to 6 weeks.
- Symptoms can include:
- A rough, reddish-brown rash that appears on the palms of your hands or the soles of your feet, which normally does not itch.
- Rashes on other parts of the body, including the neck, head and torso.
- Condylomata lata or syphilitic "warts", moist, raised or elevated skin lesions, may be found in the anus or genital area.
- "Mucous patches," flat, round, grayish-white sores, can appear on the mouth, throat, and cervix.
- Patchy loss of hair on the head and other parts of the body.
- A general sense of ill health.
- Symptoms of secondary syphilis will clear up with or without treatment, but the disease will still be present if untreated. It will then enter into a latent stage, which has no signs or symptoms.
Latent Stage
- Latent syphilis is defined as the time where there are no signs or symptoms of the disease
- Develops from two to 30+ years after infection.
- Because there are no signs or symptoms, the only way to test for infection during the latent period is by blood test.
- A relapse of secondary syphilis can occur once the disease has entered the latent stage. This normally will happen during the first two years of latency.
Late Stage (Tertiary)
- Symptoms of late stage or tertiary syphilis can occur 2 to 30+ years after infection.
- Complications during this stage can include:
- Gummas: Small bumps or tumors that can develop on the skin, bones, liver or any other organ.
- Problems with heart and blood vessels
- Chronic nervous system disorders, such as blindness, insanity and paralysis
- If treated during this period, gummas will usually disappear. Though treatment at this phase will cure the disease and stop future damage to the body, it cannot repair or reverse the damage that occurred before treatment.
Congenital Syphilis
A mother infected with syphilis can pass the disease to her unborn child, either during pregnancy or in childbirth. A newborn infected in this manner has congenital syphilis.
- Early signs generally appear from three to eight weeks after a baby is born.
- Even though these symptoms develop soon after birth, most cases go unnoticed until late congenital symptoms appear in childhood or adolescence.
- Late congenital syphilis has similar symptoms to tertiary syphilis in adults, though heart complications rarely occur in cases of congenital syphilis
How can I find out if I have syphilis?
Syphilis can be detected by blood tests, which looks for antibodies, or by testing fluid taken from lesions or swollen lymph nodes, which occur during primary or secondary syphilis. Tests on the lymphatic fluid or lesions look for antigens.
Darkfield Exam
- This test uses a fluid sample taken from the chancre during primary syphilis or from symptoms that occur during secondary syphilis found in areas such as the vagina (women) or the urethra (men).
- The sample is then viewed under a microscope.
- This test can only be done during primary or secondary syphilis, when sores, lesions & warts are present.
Blood Tests
- There are two types of blood tests used to detect syphilis: nontreponemal and treponemal. These tests can be done in all stages of syphilis.
- Nontreponemal blood tests are screening tests that look for certain antibodies , but not specifically syphilis antibodies. There are two types of screening test that may be used:
- VDRL (Venereal Disease Research Laboratory)
- or RPR (Rapid Plasma Reagent)
- If the results for these test come back positive, a more specific treponemal blood test is performed to confirm a positive result. There are two types of confirmatory tests that may be used:
- FTA-ABS (Fluorescent Treponemal Antibody Absorption Test)
- MHA-TP (Microhemagglutination-Treponema Pallidum)
- There is a possibility of a false positive, particularly if the person tested has had syphilis before. A test may also be a false positive result if you are pregnant, have rheumatoid arthritis, use heroin, or have hepatitis, influenza or pneumonia.
Cerebrospinal Fluid Test
- Another test uses cerebrospinal (involving the brain and spinal chord) fluid and is usually done if a person has damage to their central nervous system.
Testing in Infants
- If no signs and symptoms are found at birth, a blood test should be performed every 2 to 3 months on the infant until the test comes back negative. This is because an infant may test positive for syphilis and not be infected until the mother's antibodies, transmitted during pregnancy, clear the infant's body. For more information about testing and treatment of infants, talk with your health care provider, or visit your local health department.
What is the treatment for syphilis?
- The preferred treatment for syphilis is penicillin. If you are allergic to penicillin, your health care provider can suggest another antibiotic.
- If you have HIV, tell your health care provider. The antibiotic may not be as effective.
- Penicillin is the only recommended treatment for pregnant women. If you are pregnant and are allergic to penicillin, talk to your health care provider. He/she can use a process called desensitization that may allow a person to take penicillin.
- Infants should be checked carefully at birth. Treatment can vary for many reasons. For more information about testing and treatment of infants, talk with your health care provider, or visit your local health department.
Treatment Follow Up
- Take all medications as directed.
- All partners should be examined and treated.
- Do not have sex until you and your partner(s) have been treated and cured.
- After treatment for primary or secondary syphilis, it is recommended that a person be retested after 6 months, and once again after a year.
- If you are treated in the latent period, follow up tests are recommended after 6 months, 12 months & again at 24 months.
- People who are infected with syphilis and also have HIV, should be retested every 3 months for 2 years.
What can I do to reduce my risk of getting syphilis?
- Abstinence (not having sex).
- Mutual monogamy (having sex with only one uninfected partner).
- Latex condoms for vaginal and anal sex. Condoms may protect the penis or vagina from infection, but do not protect from contact with other areas such as the scrotum or anal area.
- Several barrier methods can be used to reduce the risk of transmission of syphilis during oral sex. A non-lubricated condom can be used for mouth-to-penis contact. Household plastic wrap, a dental dam, or a latex condom cut-up and opened flat can reduce the risk of transmission during mouth-to-vulva/vagina or oral-anal (rimming) contact.
Why worry?
If you do not get treated, syphilis can cause blindness, paralysis, and problems with your bones and internal organs, including your heart.
Do I need to talk to my partner about syphilis?
Yes. Telling a partner can be hard, but keep in mind that some people with syphilis don't know they have it. It's important that you talk to your partner as soon as possible so she or he can get treatment. Also, it is possible to pass syphilis back and forth, so if you get treated and your partner doesn't, you may get infected again.
Should I talk to my health care provider about syphilis?
Yes. Because syphilis often does not have symptoms, you may need to talk to your health care provider about whether or not you should be tested. If you are having unprotected sex or discover that your partner is having unprotected sex with another person, you may want to ask your health care provider about being tested.
Where can I get more information?
If you have additional questions about syphilis, call the CDC National STD and AIDS Hotlines at 1-800-342-2437 or 1-800-227-8922. The hotlines are open 24 hours a day, seven days a week. For information in Spanish call 1-800-344-7432, 8:00 AM to 2:00 AM Eastern Time, seven days a week. For the Deaf and Hard of Hearing call 1-800-243-7889, 10:00 AM to 10:00 PM Eastern Time, Monday through Friday.
Find information about other STDs What is syphilis?
- Syphilis is a curable infection caused by the bacteria Treponema pallidum.
- The bacteria enter the body through mucous membranes or abraded skin.
- Once inside the body, syphilis enters the blood stream and attaches to cells,
damaging organs over time.
- There are four stages through which untreated syphilis progresses, each stage
with its own unique signs and symptoms:
- primary
- secondary
- latent
- tertiary (or late)
How common is it?
- Up until 2000, the reported rate of syphilis in the United States was at
its lowest level since reporting began in 1941. In 2001, the number of cases
reported increased slightly by a little over 2%.
- This increase occurred only among men, while the number of cases continued
to decline among women and among African American blacks.
- Most of the reported syphilis cases are in the Southeast of the country,
with a higher percentage of cases among African-Americans than whites. In 2001,
the South had the highest rate of syphilis, accounting for 56% of reported cases
in the US.
- While rates appear to be improving, syphilis continues to disproportionately
affect African Americans, with reported rates 16 times higher for African Americans
than for white Americans.
- Syphilis rates usually increase and decrease in seven-to-ten year cycles,
which maybe one reason for the increase.
How can I get syphilis?
Sexual
- Syphilis transmission can occur when infected lesions come in contact with
the soft skin of the mucous membrane found inside the vagina, urethra or with
an abrasion during vaginal, oral and anal sex, even if there is no sexual penetration.
- It is most easily spread during the first stage because symptoms usually
go unnoticed.
- Syphilis can also be contracted from exposure to lesions or syphilitic "warts" during
the secondary stage.
- If "warts" are present, they may easily spread the syphilis bacteria, due to
the large amount of virus present.
- Because symptoms of secondary syphilis can recur, a person who has entered
the latency stage of syphilis can still transmit the disease.
Nonsexual
- Because syphilis bacteria are extremely fragile, they cannot be spread during
contact with objects such as toilet seats or towels.
- People, especially health care workers, can be at risk for syphilis if an
abrasion or cut on the skin comes into contact with a syphilitic lesion Mother-to-Child
- Syphilis can also be transmitted during pregnancy or during childbirth from
a mother to her infant. What are the symptoms of syphilis?
Primary Syphilis
- Chancre
The primary stage of syphilis is usually marked by the appearance of
a single sore, known as a chancre, within 10 to 90 days after contact with the
bacteria at the site of infection. o It is usually appears as a single, painless
sore, that is raised or elevated.
- Chancres may be found:
- outside the genitals, including the penis, scrotum and vagina
- inside the vagina or rectum
- at or around the anus
- on the lips or in the mouth, though this is not as common.
- The sore can last from one to five weeks and will go away by itself.
- The chancre will go away with or without treatment. Without treatment, the
person will still have syphilis and can transmit it to others.
- The secondary stage of syphilis can develop 17 days to 6 1/2 months after
infection.
- Symptoms can last from 2 to 6 weeks.
- Symptoms can include:
- A rough, reddish-brown rash that appears on the palms of your hands or
the soles of your feet, which normally does not itch. o Rashes on other parts
of the body, including the neck, head and torso.
- Condylomata lata or syphilitic "warts", moist, raised or elevated skin
lesions, may be found in the anus or genital area. o "Mucous patches," flat,
round, grayish-white sores, can appear on the mouth, throat, and cervix.
- Patchy loss of hair on the head and other parts of the body.
- Symptoms of secondary syphilis will clear up with or without treatment, but
the disease will still be present if untreated. It will then enter into a latent
- Latent syphilis is defined as the time where there are no signs or symptoms
of the disease
- Develops from two to 30+ years after infection.
- Because there are no signs or symptoms, the only way to test for infection
during the latent period is by blood test.
- A relapse of secondary syphilis can occur once the disease has entered the
latent stage. This normally will happen during the first two years of latency.
Late Stage (Tertiary)
- Symptoms of late stage or tertiary syphilis can occur 2 to 30+ years after
infection.
- Complications during this stage can include:
- Gummas: Small bumps or tumors that can develop on the skin, bones, liver
or any other organ.
- Problems with heart and blood vessels
- Chronic nervous system disorders, such as blindness, insanity and paralysis
- If treated during this period, gummas will usually disappear. Though treatment
at this phase will cure the disease and stop future damage to the body, it cannot
repair or reverse the damage that occurred before treatment.
Congenital Syphilis
A mother infected with syphilis can pass the disease to her unborn child,
either during pregnancy or in childbirth. A newborn infected in this manner has
congenital syphilis.
- Early signs generally appear from three to eight weeks after a baby is born.
- Even though these symptoms develop soon after birth, most cases go unnoticed
- Late congenital syphilis has similar symptoms to tertiary syphilis in adults,
though heart complications rarely occur in cases of congenital syphilis.
How can I find out if I have syphilis?
Syphilis can be detected by blood tests, which looks for antibodies, or by testing
fluid taken from lesions or swollen lymph nodes, which occur during primary or
secondary syphilis. Tests on the lymphatic fluid or lesions look for antigens. Darkfield Exam
- This test uses a fluid sample taken from the chancre during primary syphilis
or from symptoms that occur during secondary syphilis found in areas such as
the vagina (women) or the urethra (men).
- The sample is then viewed under a microscope.
- This test can only be done during primary or secondary syphilis, when sores,
lesions & warts are present.
Blood Tests
- There are two types of blood tests used to detect syphilis: nontreponemal
and treponemal. These tests can be done in all stages of syphilis.
- Nontreponemal blood tests are screening tests that look for certain antibodies
, but not specifically syphilis antibodies. There are two types of screening
test that may be used:
- VDRL (Venereal Disease Research Laboratory)
- or RPR (Rapid Plasma Reagent)
- If the results for these test come back positive, a more specific treponemal
blood test is performed to confirm a positive result. There are two types of
confirmatory tests that may be used:
- FTA-ABS (Fluorescent Treponemal Antibody
Absorption Test)
- There is a possibility of a false positive, particularly if the person tested
has had syphilis before. A test may also be a false positive result if you are
pregnant, have rheumatoid arthritis, use heroin, or have hepatitis, influenza
or pneumonia.
Cerebrospinal Fluid Test
- Another test uses cerebrospinal (involving the brain and spinal chord) fluid
and is usually done if a person has damage to their central nervous system. Testing
in Infants
- If no signs and symptoms are found at birth, a blood test should be performed
every 2 to 3 months on the infant until the test comes back negative. This is
because an infant may test positive for syphilis and not be infected until the
mother's antibodies, transmitted during pregnancy, clear the infant's body. For
more information about testing and treatment of infants, talk with your health
care provider, or visit your local health department. What is the treatment
for syphilis?
- The preferred treatment for syphilis is penicillin. If you are allergic to
penicillin, your health care provider can suggest another antibiotic.
- If you have HIV, tell your health care provider. The antibiotic may not be
- Penicillin is the only recommended treatment for pregnant women. If you are
pregnant and are allergic to penicillin, talk to your health care provider. He/she
- Infants should be checked carefully at birth. Treatment can vary for many
reasons. For more information about testing and treatment of infants, talk with
your health care provider, or visit your local health department.
- Take all medications as directed.
- All partners should be examined and treated.
- Do not have sex until you and your partner(s) have been treated and cured.
- After treatment for primary or secondary syphilis, it is recommended that
a person be retested after 6 months, and once again after a year.
- If you are treated in the latent period, follow up tests are recommended
- People who are infected with syphilis and also have HIV, should be retested
every 3 months for 2 years.
What can I do to reduce my risk of getting syphilis?
- Abstinence (not having sex).
- Mutual monogamy (having sex with only one uninfected partner).
- Latex condoms for vaginal and anal sex. Condoms may protect the penis or
vagina from infection, but do not protect from contact with other areas such
as the scrotum or anal area.
- Several barrier methods can be used to reduce the risk of transmission of syphilis
during oral sex. A non-lubricated condom can be used for mouth-to-penis contact.
Household plastic wrap, a dental dam, or a latex condom cut-up and opened flat
can reduce the risk of transmission during mouth-to-vulva/vagina or oral-anal
(rimming) contact.
Why worry?
If you do not get treated, syphilis can cause blindness, paralysis, and problems
with your bones and internal organs, including your heart.
Do I need to talk to my partner about syphilis?
Yes. Telling a partner can be hard, but keep in mind that some people with
syphilis don't know they have it. It's important that you talk to your partner
as soon as possible so she or he can get treatment. Also, it is possible to
pass syphilis back and forth, so if you get treated and your partner doesn't,
you
may get infected again.
Should I talk to my health care provider about syphilis?
Yes. Because syphilis often does not have symptoms, you may need to talk
to your health care provider about whether or not you should be tested. If you
are
having unprotected sex or discover that your partner is having unprotected
sex with another person, you may want to ask your health care provider about
being
tested.
Where can I get more information?
If you have additional questions about syphilis, call the CDC National STD
and AIDS Hotlines at 1-800-342-2437 or 1-800-227-8922. The hotlines are open
24 hours a day, seven days a week. For information in Spanish call 1-800-344-7432,
8:00 AM to 2:00 AM Eastern Time, seven days a week. For the Deaf and Hard of
Hearing call 1-800-243-7889, 10:00 AM to 10:00 PM Eastern Time, Monday through
Friday.
Find information about other STDs
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