Gay men and other men who have sex with men (MSM) are being urged to prioritise regular STI screening, as data points to rising infections in Gauteng and hidden risks — particularly when it comes to syphilis.
The call was made by OUT LGBT Well-being’s Pretoria-based +DR clinic, which provides inclusive, patient-centred online and in-person medical services for LGBT+ communities.
OUT revealed that in its work in Johannesburg, it found that 15% of MSM who showed no symptoms tested positive for a sexually transmitted infection (STI). Reinforcing these concerns, data from the Gauteng Department of Health shows that the percentage of men with STIs in the province rose from 12% in 2020 to 15% in 2023.
Of particular concern is syphilis, which can go unnoticed for long periods while still causing serious harm and being easily transmitted.
“Syphilis is often called a ‘silent’ infection because people may not realise they have it,” says Dawie Nel from +DR. “You can feel completely fine and still be living with an infection that can be passed on to others and lead to serious complications if left untreated.”
Why Syphilis Matters
Syphilis is a bacterial STI spread through direct sexual contact, especially during condomless anal, oral, or vaginal sex. It develops in stages, each with different symptoms — and sometimes none at all.
In its early stage, syphilis may appear as a single painless sore on or around the genitals, anus, or mouth. Because it doesn’t hurt, many people miss it. Later stages can include rashes, fatigue, swollen glands, and other symptoms that may come and go.
If untreated, syphilis can remain in the body for years and, in rare cases, lead to serious complications affecting the brain, heart, and other organs.
“The key message is simple: don’t wait for symptoms,” says Nel. “Regular testing is the only reliable way to know your status and protect your health and your partners.”
The Link Between Syphilis and HIV
Syphilis does not exist in isolation — it can also increase the risk of HIV transmission.
Having a sore or break in the skin caused by an STI such as syphilis can make it easier for HIV to enter the body. In addition, the same behaviours and circumstances that increase the risk of contracting STIs can also increase vulnerability to HIV.
“Protecting yourself from STIs like syphilis is also part of protecting yourself from HIV,” Nel explains. “These infections are closely linked, which is why regular screening and prevention are so important.”
Treatment and Prevention
Thankfully, syphilis is easily treatable with antibiotics, although if left late, treatment might not undo damage the infection may have caused. This again highlights the importance of regular testing.
Prevention options for syphilis include reducing the number of sexual partners and using condoms during sex. Screening for syphilis is advised annually.
In addition, Doxy PEP (doxycycline post-exposure prophylaxis) can be very effective. This entails taking a single 200 mg dose of prescribed antibiotics (doxycycline) within 72 hours after condomless sex to reduce the risk of bacterial STIs, including syphilis.
“When used correctly, Doxy PEP can be a powerful additional tool for people at higher risk,” Nel says. “It can significantly reduce the chances of infection when combined with regular screening.”
+DR is offering a free syphilis antibody (Ab) test to any client attending an in-person consultation during May 2026. To claim the offer, use the promo code “SYPHILIS”. For more information, WhatsApp: 072 113 6597.
