Syphilis guide: Prevention and control
This guide is about management of primary, secondary, latent and tertiary syphilis. Some information about neurosyphilis and congenital syphilis is included, however their treatment is outside the scope of this document. Individuals with these conditions should be managed by or in consultation with an infectious disease specialist or an experienced colleague.
Last partial content update: November 2025
Information about general STBBI prevention and control was modified to align with content in the STBBI-associated syndromes guide and STBBI prevention guide.
A note about consideration of doxycycline for the prevention of chlamydia, gonorrhea and syphilis was incorporated, along with a link to the biomedical prevention page in the STBBI prevention guide.
This information is captured in the table of updates to the guides.
On this page
- General sexually transmitted and blood-borne infection (STBBI) prevention and control
- Prevention and control of syphilis
- References
General sexually transmitted and blood-borne infection (STBBI) prevention and control
Effective prevention strategies can reduce the impact of STBBI.
Encouraging the use of barrier devices, facilitating safer substance use practicesFootnote 1 Footnote 2 and offering vaccinations and other biomedical prevention strategies (e.g., HIV pre- and post-exposure prophylaxis (HIV PrEP/ HIV PEP), doxycycline prophylaxis) are components of comprehensive STBBI prevention services.
Healthcare providers should offer STBBI screening as part of their prevention and control strategies. Since many STBBI are frequently asymptomatic and can lead to serious complications if left undiagnosed and untreated, offer STBBI screening in the course of routine medical care, with special attention to those with epidemiological and behavioural risk factors. Normalizing screening in this way can reduce barriers to testing and the stigma associated with STBBIs.
Motivational interviewing may be used to identify barriers to prevention practices and the means to overcome them.
Partner notification has public health benefits (e.g. disease surveillance and control), can prevent complications for partner(s), and reduces the risk of re-infection for the index case.
Prevention and control of syphilis
Measures to prevent and control the transmission of syphilis include counselling, considerations of prophylactic doxycycline, prompt diagnosis and appropriate treatment of the person and their sexual partners.
For current recommendations about the prophylactic use of doxycycline for the prevention of chlamydia, gonorrhea and syphilis, refer to the biomedical prevention page in the STBBI prevention guide.
Counsel people with suspected or confirmed syphilis at the time of diagnosis about:
- Potential for transmission to sexual partners
- The possibility of re-infection (since infection with syphilis results in only partial immunity)Footnote 3Footnote 4Footnote 5
- Advise all people with potentially infectious lesions such as chancres, condylomata lata and/or rash of secondary syphilis to abstain from sexual contact until symptoms have resolvedFootnote 6 and for 7 days after treatment.
- Prevention of congenital syphilis for people of childbearing age
- Vulnerability to other STBBI
- The importance of STBBI screening
References
- Footnote 1
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Community AIDS Treatment Information Exchange (CATIE). Safer substance use and hepatitis C prevention. 2021. Available at: https://www.catie.ca/hepatitis-c-an-in-depth-guide/safer-substance-use-and-hepatitis-c-prevention
- Footnote 2
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Community AIDS Treatment Information Exchange (CATIE). Harm reduction and hepatitis C. 2021. Available at: https://www.catie.ca/hepatitis-c-an-in-depth-guide/harm-reduction-and-hepatitis-c
- Footnote 3
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Kerani R, Lukehart S, Stenger M, Marra C, Pedersen R, Golden M. Is early latent syphilis more likely in patients with a prior syphilis infection. London: British Society for Sexual Health and HIV, Presentation at: 18th International Society for STD Research. 2009.
- Footnote 4
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Morgan CA, Lukehart SA, Van Voorhis WC. Protection against syphilis correlates with specificity of antibodies to the variable regions of treponema pallidum repeat protein K. Infect Immun. 2003;71(10):5605-5612.
- Footnote 5
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Ivens D, Patel M. Incidence and presentation of early syphilis diagnosed in HIV-positive gay men attending a central london outpatients' department. Int J STD AIDS. 2005;16(3):201-202.
- Footnote 6
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Tosca A, Lehou J, Hatjivasiliou M, Varelzidis A, Stratigos JD. Infiltrate of syphilitic lesions before and after treatment. Genitourin Med. 1988;64(5):289-293.