You've got your test result. Positive. Syphilis. Maybe your stomach dropped for a second, maybe you already had a hunch. However you're feeling right now: take a deep breath. Here's the short version of everything that follows: syphilis is very treatable and, in almost all cases, completely curable. Usually a course of antibiotics is enough and that's that. By getting tested, you did the right thing. Now it's just about taking the next step.

What is syphilis, actually?

Syphilis, once also called lues, is a bacterial infection. It's passed on through direct contact with the infectious areas of skin, during vaginal, anal or oral sex. That can happen even when no bodily fluids are exchanged, because skin contact with an infectious spot is already enough.

Syphilis is especially contagious in the early stages. Condoms lower the risk considerably, but don't protect completely, because the infectious spots can also lie outside the area a condom covers.

Do you even notice anything?

The tricky thing about syphilis: it moves in stages and can go completely unnoticed in between.

First stage: About three weeks after infection, a small, usually painless ulcer forms at the point of entry. Because it doesn't hurt and disappears on its own, it often gets overlooked.

Second stage: Weeks later, a rash (often on the palms and the soles of the feet), fever, swollen lymph nodes or a general feeling of being unwell can appear. These signs also fade on their own again.

Latent stage: After that, the infection can persist for years without any symptoms at all.

Precisely because the symptoms come and go, a test is often the only reliable way to find out.

Why should I take this seriously?

Because an untreated syphilis infection doesn't simply go away, even when the symptoms retreat. Over the years it can do serious damage, among other things to the heart, nervous system and brain. That's rare today, because most cases are treated early, but that's exactly the point: treat it early.

On top of that: an active syphilis infection raises the risk of catching HIV or passing HIV on. And during pregnancy it can be passed to the child. All of this can be prevented as soon as treatment starts. And you're already on your way there.

What happens now? The next steps

Get it checked medically. A positive confirmatory test shows whether your body has had contact with the pathogen. Which stage you're at and whether treatment is needed right now is something doctors work out using further blood values. The right places to go include specialist practices, dermatologists, your GP practice or an STI clinic.

Start treatment. Syphilis is treated with antibiotics. In early stages a single dose is usually enough, in later stages it's several. Exactly how it's treated is something your doctors will decide. The treatment is straightforward and, as a rule, very effective.

No sex until it's cleared. As long as the treatment isn't finished, you can infect others. Wait until your doctors give the all-clear.

Tell your contacts. People you've had sex with should get tested too. This is the part hardly anyone looks forward to, but it gives others the chance to know early. How far back you should go is something your doctors will tell you.

Go to the follow-up. After treatment, blood checks are used to see whether it worked. These appointments matter, even when you've long since felt fine again.

How do I protect myself in future?

Getting over syphilis once doesn't make you immune. You can catch it again, so protection stays relevant afterwards too.

• Use condoms, knowing that they lower the risk but don't rule it out completely
• Test regularly, especially with changing partners
• Get tested early at signs like a painless ulcer or an unexplained rash

Testing regularly is the most effective lever, because syphilis so often runs its course without clear symptoms. An at-home self-test is possible with Reality Check.

No reason to panic

Testing positive for syphilis isn't a catastrophe, even if it might feel that way at first. Syphilis is one of the STIs that can be cured reliably and, in most cases, without complications. One thing matters above all: stick with it, get treated and go to the follow-up. You've already taken the most important step. Now it's just about seeing it through.