Syphilis cases are on the rise in Australia, with case numbers more than doubling over the past decade (2014 – 2024) (1). Due to the scale and severity, syphilis was declared a Communicable Disease Incident of National Significance (CDINS) in 2025 by the Australian Centre for Disease Control (CDC) (2).
Syphilis can affect anyone, with cases increasing across all demographics. However, pregnant people, gay and bisexual men, men who have sex with men, and First Nations communities are disproportionately affected. If untreated, syphilis can cause serious health complications, long‑term disability or be life‑threatening.
To combat the rise in syphilis cases, the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) are raising awareness through the National Syphilis Awareness Campaign, encouraging health professionals to strengthen their awareness and understanding of syphilis.
Following the declaration of syphilis as a CDINS, ASHM commissioned a national survey to inform the development of a National Syphilis Awareness Campaign. The sample was diverse across professional roles and settings. The national survey of 819 healthcare workers was conducted in late 2025 and found:
- 54% of healthcare professionals do not feel confident about when to test or refer for syphilis
- 38% believe it is their responsibility to raise sexual health with patients
- 88% feel equipped to test or refer for STIs
- Only 21% regularly talk about sexual health with patients
- Two-thirds (66%) incorrectly believe a syphilis test is part of a urine test
These findings highlight areas of concern in Syphilis awareness across the healthcare system. As a result, ASHM recommend coordinated action in preventing the spread of syphilis. Enhanced, coordinated efforts across communities, primary care, specialist services and all levels of the health system are required.
Start Testing in your Practice
Anyone who is sexually active can contract syphilis. Avoid making assumptions about a patient or their partners based on appearance, identity or relationship status. Around 1 in 6 Australians will acquire a sexually transmissible infection (STI) during their lifetime.
With almost 50% of syphilis cases often showing no symptoms, routine testing of all sexually active patients is vital to prevent its potentially devastating consequences. Screening all sexually active patients, and pregnant people during their antenatal appointments is essential.
As syphilis can mimic many other conditions, consider syphilis testing in all patients with unexplained symptoms. Clinically, the disease has 3 stages:
- Early infectious syphilis: primary and secondary and early latent infection, i.e. asymptomatic infection acquired within the previous 2 years.
- Late latent syphilis, i.e. asymptomatic infection acquired more than 2 years before diagnosis, or when the duration of infection is unknown.
- Tertiary or late symptomatic syphilis, with neurological, cardiovascular or gummatous complications.
More information on the clinical presentation of syphilis is available
Syphilis infection in a pregnant person may be transmitted to the foetus and can cause multi-organ disease associated with high rates of mortality and morbidity. Congenital syphilis is preventable if the pregnant person is treated less than 30 days before delivery. If you have a patient who has been diagnosed with syphilis during pregnancy, seek specialist advice.
Syphilis is highly curable with antibiotics. For more information on the management of syphilis, visit the STI management guidelines
The diagnosing clinician is responsible for initiating and documenting a discussion about contact tracing. Identified sexual contacts of the person with syphilis infection must be informed and offered testing. Tracing should be carried out according to sexual history and clinical stage of infection. Syphilis registers and Public Health Units can provide support. See STI Management Guidelines for more information
We can all Play a Role
We all have a role to play in putting syphilis on our radar and helping to stop the spread. Any GP can provide STI testing, including syphilis testing, and a ‘no wrong door’ approach means people should be supported to access testing wherever they engage with a health service.
Even if you are in a non-clinical role, you can help by encouraging testing, discussing STI risk, reducing stigma, and recognising possible signs and symptoms. This is particularly important for workers supporting priority populations, including people accessing drug and alcohol services, homelessness services, mental health and family violence services, and services for young people and LGBTI+ communities.
Resources are available
ASHM have created three waiting room Posters for General, Antenatal and First Nations audiences. These can be accessed here
ASHM also created a Conversation Guide to help assist all healthcare workers with patient conversations around syphilis testing and diagnosis.