Increase in syphilis cases among gay and bisexual men in the Christchurch region

Sexual health clinics provide a specialist, confidential, free of charge service to everyone. Increasingly we would like SHOPP to be a vehicle for communicating trends in clinical practice that may affect health promotion activities locally or nationwide.

The following articles – sourced from,, and ProMed – were sent in by Dr Jane Morgan, Waikato DHB Sexual Health Services.

An increase or an increase in testing?

The article

There’s been an increase in syphilis cases among gay and bisexual men in the Christchurch region, following similar trends in Auckland and Hamilton. The New Zealand AIDS Foundation [NZAF] says average monthly syphilis cases in Christchurch have increased 100 per cent over the past 18 months. [The NZAF is] encouraging gay and bisexual men to use condoms and lube for anal sex and to get tested.

The NZAF says if a person has syphilis, they are also more likely to get HIV and pass it on. “It is vital to continue to use condoms and lube for anal sex because unprotected anal sex makes it easy for STIs [sexually transmitted infections] and HIV to be passed on. Evidence shows that 8 in 10 gay and bisexual Kiwis use condoms for anal sex with casual partners and we encourage them to continue doing so.”

It’s possible to have syphilis with no symptoms and it is also possible to pass it onto others when you don’t have symptoms. Many people who have syphilis aren’t aware they have it, particularly if it’s in their throat or rectum.

Syphilis can produce a painless sore on the penis, in the anus or in the mouth 10-90 days after infection. The sore usually turns into a scab and heals after 2-6 weeks, but the infection remains. If left untreated, syphilis can cause damage to nerves, bones, skin, eyes and brain. GPs can provide full sexual health check-ups, or free tests can be booked in Christchurch at NZAF Te Toka or Christchurch Sexual Health Services.

(Source:, with further reporting from ProMed below (ProMED – the Program for Monitoring Emerging Diseases – is an Internet-based reporting system dedicated to rapid global dissemination of information on outbreaks of infectious diseases and acute exposures to toxins that affect human health)).

ProMed commentary on the matter

Some of this continued increase may be due to an increased frequency of testing for syphilis in MSM. The increasing numbers of men who have sex with men who also have unprotected sex with wives and girlfriends may lead to a rising incidence of syphilis in women and congenital syphilis.

Cases among MSM have been characterized by high rates of HIV co-infection and high-risk sexual behaviors in many localities worldwide. An article posted by ProMED-mail reported that HIV-infected MSM seek out other HIV-positive sex partners to avoid using condoms (“serosorting”), which, of course, would allow transmission of syphilis, gonorrhoea, and other sexually transmitted diseases among HIV-infected MSM, without resulting in an increase in HIV infections.

How might this influence health promotion activities?

Please comment below on how this could be used in any health promotion activities being planned, or start a discussion about how medical trends in a clinical setting can be used translated to a health promotion environment.