Concerned

  I am a gay male and  recently tested positive for syphilis and had not been tested for STDs other than HIV in about 7 years.    I have had no symptoms for syphilis at all.....  no sores /  rashes  anywhere.  I had somewhat unsafe anal sex ( receptive)  a few weeks ago (not with my partner) but that has been the only unsafe sex I have had in about 4 yrs.   I receive oral from my partner pretty regularly but we do not engage in anything else and I do not perform oral for him.  My questions are:      Is Syphilis transmitted only through contact with a chancre sore?  or can it be transmitted through semen.  Is it possible that he could have been infected with NO penile sores present if my infection was due to the receptive anal episode I had?  I guess generally I am trying to determine if syphilis is transmitted ONLY through  contact with chancre sores and can it be spread with semen  if absolutely no chancre sores are present.   I look forward to your reply.  Thanks for your help.

[Alan Rockoff, MD]

Through chancres, not semen.  A positive test for syphilis can mean syphilis, but it can also mean a prior treated case of syphilis, or sometimes other, nonsexual diseases can cause the syphilis test to be "false positive."  I am sure that the doctor who ordered the syphilis test knows this and would recommend a follow-up test to find out what to do next.  You should be working with a doctor on this, not trying to research it yourself.  Please look into this at once.

Thank you.

Dr. Rockoff