Syphilis in Salt Lake City: Symptoms, Testing and Treatment

Syphilis is a bacterial infection that has been known for centuries. It is also one of the more treatable infections a person can have, as long as it is found. The challenge is that it often looks like something else, or shows no signs at all.

This guide covers the organism behind syphilis, the stages, the rash, how blood tests work, what treatment looks like, and what the numbers say for Salt Lake County and Utah. It also covers where to get tested locally, including options that are free or low cost.

Nothing here can tell you whether you have syphilis. A clinician and a lab test can.

Quick answers

• Is syphilis curable? Yes. The CDC STI Treatment Guidelines (2021) state that syphilis is a bacterial infection that can be cured with antibiotic treatment prescribed by a clinician.
• What is the main treatment? The CDC names penicillin as the preferred treatment at every stage. A clinician chooses the exact form and schedule.
• How is it found? Usually with a blood test. Sometimes a clinician also tests fluid from a sore.
• Can it cause symptoms? It can, but many people notice nothing for long stretches.

The organism: what causes syphilis

Syphilis is caused by a spiral-shaped bacterium called Treponema pallidum, subspecies pallidum. The CDC describes it as passing from person to person through direct contact with a syphilis sore, most often during vaginal, anal or oral sex. It can also pass from a pregnant person to a baby during pregnancy.

A few features of this bacterium explain why testing and treatment work the way they do:

• It cannot be grown easily in a lab. Because of this, diagnosis relies on blood tests that look for the body's response, rather than growing the organism from a sample.
• It divides slowly. Research suggests this is one reason penicillin must stay in the body for a sustained period, and why clinicians use long-acting forms of the medicine.
• It has not developed resistance to penicillin. The CDC guidelines continue to list penicillin as the preferred therapy, which is unusual among bacterial infections.

Syphilis is not spread by toilet seats, doorknobs, shared dishes or casual contact. Anyone of any gender or orientation who has sex can be exposed, and testing is a routine part of sexual health care.

Syphilis symptoms by stage

The CDC describes syphilis in stages. The stages are a way to organize what clinicians see. Not everyone moves through them in a tidy order, and some people never notice a sign at any stage.

Primary syphilis

The first sign is usually a sore called a chancre. The CDC says it is typically firm, round and painless, and it appears where the bacterium entered the body. That could be the genitals, anus, rectum or mouth. Because it does not hurt and can be inside the body, it is easy to miss.

The CDC notes that a chancre heals on its own after a few weeks. Healing does not mean the infection is gone. Without treatment, the bacterium remains.

Secondary syphilis

This stage is where the syphilis rash often appears. The CDC describes the rash as non-itchy and variable. It may look like rough, red or reddish-brown spots, and it often shows up on the palms of the hands and the soles of the feet. It can also appear on the trunk or elsewhere, and it can be faint enough to be mistaken for another skin condition.

Other secondary signs listed by the CDC include:

• Fever, tiredness and sore throat
• Swollen lymph glands
• Patchy hair loss
• Headaches and muscle aches
• Weight loss
• Wart-like patches in warm, moist areas such as the groin

These signs can come and go. They also resemble many other conditions, which is why a rash alone cannot confirm or rule out syphilis. A clinician looks at the skin and orders a test.

Latent syphilis

The CDC describes latent syphilis as a stage with no signs or symptoms, where the infection is found only by a blood test. Clinicians sort it into early latent and late latent, or latent of unknown duration, because that affects the treatment plan. Latent does not mean harmless. It means quiet.

Tertiary syphilis and other complications

The CDC says that without treatment, a minority of people go on to develop tertiary syphilis, which can affect the heart, blood vessels, brain and other organs, usually many years after the first infection. This is the main reason public health agencies encourage testing: finding syphilis earlier avoids these outcomes.

The CDC also notes that syphilis can involve the nervous system (neurosyphilis), the eyes (ocular syphilis) or the ears (otosyphilis) at any stage. Changes in vision or hearing, severe headache or changes in thinking are reasons to seek care promptly.

Why the national rise matters

The CDC reports that syphilis cases in the United States fell to historic lows around the turn of the century, then rose again over the last two decades. The increase has included cases among women and babies, not only among the groups that were most affected earlier.

The part that concerns public health agencies most is congenital syphilis, when the infection passes to a baby during pregnancy. The CDC says congenital syphilis can lead to miscarriage, stillbirth, early death of the infant, or lasting health problems. It is also preventable when a pregnant person is tested and treated on time.

For a reader, the practical point is this. When an infection is becoming more common, a negative result from a past test says little about today. Testing is a routine, repeatable part of care, not a one-time event.

Syphilis in Salt Lake City and Utah: the numbers

Utah has historically had lower rates than many states, but local figures show syphilis is part of the picture here. These are the most recent figures available from the sources below.

Measure	Salt Lake County	Utah	Source
Primary and secondary syphilis, 2022	13.7 per 100,000 people	7.0 per 100,000 people (239 cases)	Utah IBIS-PH, Syphilis Cases
Congenital syphilis, 2023	Not published in the sources reviewed	35.0 new cases per 100,000 live births (ranked 14th)	America's Health Rankings, citing CDC AtlasPlus

Utah IBIS-PH, the state health data portal, shows Salt Lake County's 2022 primary and secondary syphilis rate at roughly twice the statewide rate. That fits a common pattern: more densely populated areas, with more clinics and more testing, often report higher numbers.

For context from the same Utah IBIS-PH data, the 2022 chlamydia rate was 479.7 per 100,000 in Salt Lake County, compared with 328.7 for Utah. The county's 2022 gonorrhea rate was 166.4 per 100,000, compared with 91.2 for the state. People who test for one STI often test for several at once, and a clinician can advise on which tests fit the situation.

Newer county-level figures may exist. For anything after 2022, check with the Salt Lake County Health Department or Utah IBIS-PH.

How syphilis is tested

Most syphilis testing is done with blood. The CDC STI Treatment Guidelines (2021) describe two families of blood tests, and clinicians typically use both together to reach an answer.

Non-treponemal tests

These tests, such as the RPR and VDRL, detect substances the body makes in response to damage from the infection. They produce a number called a titer. The titer matters because it can be compared over time. After treatment, a clinician watches whether it goes down.

These tests can occasionally be positive for reasons other than syphilis, which is why a second type of test is used to check them.

Treponemal tests

These tests detect antibodies aimed specifically at the syphilis bacterium. According to the CDC, they usually stay positive for life, even after successful treatment. That does not mean the infection is active. It reflects a lasting immune memory.

Two orders of testing

The CDC describes two approaches. Some laboratories begin with the non-treponemal test and confirm with a treponemal one (the traditional algorithm). Others begin with a treponemal test and follow with a non-treponemal one (the reverse sequence algorithm). Either way, the result depends on both kinds of information. You do not need to choose; the clinic or lab handles it.

Testing a sore

If there is an open sore, a clinician may take a sample from it for a direct test. The CDC notes that early in the infection, blood tests may not yet be positive, so a clinician may suggest repeat testing after a short interval.

Timing after a possible exposure

The CDC does not give one simple window period that fits every test and every person. If you think you may have been exposed recently, ask a clinician when to test and whether to retest. The clinic can use your specific situation to decide.

Who is advised to test

The U.S. Preventive Services Task Force (USPSTF) recommends syphilis screening for people at increased risk, and for all pregnant people. The CDC guidelines encourage screening at least yearly for sexually active men who have sex with men, with more frequent screening for those at higher risk. They also recommend that people with HIV be screened, and that anyone who has been diagnosed with another STI discuss syphilis testing with a clinician. In Utah, the state health department cites Utah Code 26B-7-216, which calls for syphilis screening of all pregnant patients within 10 days of the first exam. Whether additional screening is required later in pregnancy is not stated in the sources reviewed, so ask your prenatal provider.

Syphilis treatment: is syphilis curable?

Yes. Syphilis is curable with antibiotic treatment from a clinician. The CDC guidelines name penicillin as the preferred treatment for all stages, and as the only recommended treatment during pregnancy.

What matters for the reader:

• Only a clinician prescribes and gives syphilis treatment. This guide does not list doses or schedules, because the right plan depends on the stage, the test results and the person.
• The stage changes the plan. Per the CDC, earlier-stage infection generally involves a shorter course than later or unknown-duration infection. If the nervous system, eyes or ears are involved, treatment may be different and may happen in a hospital.
• Treatment stops further damage but may not reverse existing damage. This is another reason earlier testing helps.
• Being treated once does not prevent getting syphilis again. The CDC notes that people can be reinfected.

Sexual partners

The CDC advises that recent sexual partners of someone with syphilis should be tested and may be offered treatment. Local health departments can help with this, often without naming the person who tested positive. The clinic can explain how that works. For some infections, Utah allows expedited partner therapy, in which a clinician provides treatment for a partner without a visit. According to the Utah Department of Health and Human Services, in Utah this covers chlamydia and gonorrhea. It is not listed for syphilis, so partners of someone with syphilis should be evaluated by a clinician.

Follow-up blood tests

Treatment is not the last step. The CDC recommends follow-up blood tests after treatment to confirm that the non-treponemal titer is falling as expected. The timing depends on the stage and on factors such as HIV status or pregnancy, and a clinician sets the schedule. Research suggests that a titer decline over months is the usual sign of a good response. Because the treponemal test often stays positive for life, the follow-up relies mainly on the non-treponemal number.

If the titer does not fall as expected, the clinician may recommend additional evaluation. That is routine follow-up, not a sign that something was done wrong.

Safety profile of treatment

Penicillin has been used for syphilis for decades. The CDC guidelines and published research describe a few points a clinician will discuss.

Penicillin allergy

Many people who believe they are allergic to penicillin are not, according to allergy research. The CDC notes that penicillin allergy evaluation is worthwhile because penicillin is so important for syphilis. Tell the clinician about any past reaction. In pregnancy, the CDC guidelines recommend that a person with a confirmed allergy be desensitized and then treated with penicillin, because other options are not considered reliable for protecting the baby.

Jarisch-Herxheimer reaction

Some people have a short-lived reaction within the first day after treatment, with fever, chills, headache and muscle aches. The CDC describes this as a response to the bacteria breaking down, not an allergy. It is more commonly reported in early syphilis. Ask the clinician what to expect and whom to call. In pregnancy, a clinician may recommend monitoring.

Other considerations

• Tell the clinician if you are pregnant, may be pregnant, or are breastfeeding.
• Tell the clinician about all other medicines and any bleeding or clotting conditions, since penicillin for syphilis is often given by injection.
• Alternatives to penicillin exist for some non-pregnant people with allergies, and the clinician decides whether they are suitable.

Doxy-PEP and syphilis

In 2024 the CDC published guidance on doxycycline taken after sex, known as doxy-PEP. The CDC recommends that clinicians discuss it with gay, bisexual and other men who have sex with men, and with transgender women, who have had a bacterial STI in the past year. Research cited by the CDC suggests it lowers the chance of syphilis, chlamydia and gonorrhea in these groups.

Doxy-PEP is a prescription decision made with a clinician. It does not replace regular testing, and it does not treat an existing syphilis infection. The Salt Lake County Health Department's clinic lists doxy-PEP among its services.

Quality indicators: what to look for in testing and care

You do not need to evaluate laboratories, but a few points signal good care:

• The clinic orders a full panel for the situation. Syphilis testing often fits alongside HIV, chlamydia and gonorrhea testing, and the CDC encourages clinicians to discuss all of them.
• Results are explained, not just delivered. A clinician should say what a treponemal and non-treponemal result mean together, and what happens next.
• A follow-up plan is stated. If treatment happens, ask when the repeat blood test is due.
• Privacy is addressed. In Utah, per the Utah Department of Health and Human Services, people 14 and older can consent to STI care without a parent (Utah Code 26B-7-214, as cited by Utah IBIS).
• Costs are stated up front. If a price is not listed, ask before the visit.

This guide does not recommend any home kit, brand or mail-in product. If a test was done outside a clinic, a clinician can help you interpret it.

Where to get tested in Salt Lake City

The list below includes free and low-cost options. For more detail on each, see our guide to where to get tested in Salt Lake City. Hours and prices can change, so call before you go.

Salt Lake County Health Department, STD Clinic / Infectious Disease Clinic

• Address: 610 South 200 East (enter from 200 East), Salt Lake City
• Phone: 385-468-4242. The STD Prevention Program is 385-468-4185.
• Hours: Monday to Friday, 8:00 AM to 5:00 PM. The clinic says it is closed until 1:00 PM on the 1st and 3rd Wednesday of each month.
• Walk-ins: Accepted when possible. Appointments shorten the wait. The county health department's directory listing for the Salt Lake City Public Health Center (385-468-4225) says walk-ins are permitted but calling ahead is preferred.
• Fees the clinic publishes: an office visit is $60 for Salt Lake County residents and $80 for people outside the county. There is no office visit fee if the only test is for HIV. A syphilis test is listed at $40, an HIV blood test at $50, and chlamydia or gonorrhea testing at $40 per site. Rapid HIV testing is free for high-risk individuals while grant funds last. The clinic states that it cannot bill health insurance.
• Age: Testing is available to anyone 14 or older.
• Other services listed: HIV testing, PrEP, doxy-PEP and treatment.

More at the Salt Lake County Health Department's testing page.

Planned Parenthood Association of Utah, Salt Lake Health Center

• Address: 654 S 900 E, Salt Lake City, UT 84102
• Phone: (801) 322-5571
• Details: The CDC GetTested listing says an appointment is required, insurance and Medicaid are accepted, and fees are on a sliding scale. It lists tests for HIV, hepatitis B and C, herpes, chlamydia, gonorrhea and syphilis. Hours are not listed, so check with the clinic.

Community Health Centers Inc.

• Oquirrh View Community Health Center, 4745 S 3200 W, (801) 964-6214. The CDC GetTested listing says appointments are required.
• Ellis R. Shipp Clinic, 4535 S 5600 W, (801) 676-4405.
• Details: Both are listed with a sliding scale and accept insurance, Medicaid and Medicare. The listings include syphilis, chlamydia, gonorrhea, herpes and HIV testing. Hours are not listed, so call to confirm.

University of Utah Health, Redwood Health Center (HIV PrEP Program)

• Address: 1525 W 2100 S, Salt Lake City, UT 84119
• Phone: (801) 213-9900
• Details: The CDC GetTested listing includes HIV, chlamydia, gonorrhea and syphilis testing, plus PrEP navigation. Insurance is accepted, and PrEP assistance is listed for people without insurance. Hours are not published there.

University of Utah Student Health Center

• Address: 555 Foothill Dr, Level 1, Salt Lake City, UT 84112
• Phone: 801-581-6431
• Details: HIV and STI testing by appointment, with a visit fee and lab charges. The page also describes Campus Wellness mobile clinics with free HIV, gonorrhea and chlamydia testing for people without symptoms. The page does not say whether people who are not students can use the center, so ask before booking.

Utah Naloxone (Andy's Wellness Center)

• Address: 525 East 100 South, Suite 4400, Salt Lake City, UT 84102
• Phone: (385) 495-9050
• Details: A harm reduction program whose directory listing includes HIV testing, hepatitis C testing, and STI testing and treatment. The listed hours are Monday, Thursday and Friday, 10:30 AM to 4:30 PM. Cost and walk-in policy are not stated, so call to ask.

To find more sites by ZIP code, the CDC offers a national directory at gettested.cdc.gov.

What to ask at your visit

• Which tests are being done, and does that include syphilis?
• How and when will I get results?
• If treatment is needed, what is the plan, and when is the follow-up blood test?
• How do I let partners know, and can the health department help?
• Is it worth discussing PrEP or doxy-PEP?

Asking about syphilis is a normal request. Clinicians handle these questions every day, and getting tested is one of the most useful things a person can do for their own health and for the people around them.

Key takeaways

• Syphilis is caused by a bacterium and is curable with penicillin from a clinician.
• Symptoms may be a painless sore, a non-itchy rash, or nothing noticeable. Only a test can say.
• Testing uses two kinds of blood test that are read together.
• Follow-up blood tests after treatment are part of the plan.
• Salt Lake County's 2022 primary and secondary syphilis rate of 13.7 per 100,000 was about twice Utah's rate of 7.0, per Utah IBIS-PH.
• Free and low-cost testing is available locally, and you can find more sites at gettested.cdc.gov.

Sources

• CDC, Sexually Transmitted Infections Treatment Guidelines, 2021: Syphilis
• CDC, About Syphilis
• CDC, Clinical Guidelines on the Use of Doxycycline Postexposure Prophylaxis for Bacterial STI Prevention, 2024
• CDC GetTested, National HIV, STD and Hepatitis Testing
• Salt Lake County Health Department, Infectious Disease Clinic testing information
• Utah IBIS-PH, Syphilis Cases (Primary and Secondary)
• Utah IBIS-PH, Chlamydia Cases
• Utah IBIS-PH, Gonorrhea Cases
• Utah Department of Health and Human Services, Congenital Syphilis (Utah Code 26B-7-216)
• Utah DHHS IBIS, available services and minor consent (Utah Code 26B-7-214)
• Utah DHHS, Expedited Partner Therapy
• America's Health Rankings, Congenital Syphilis in Utah (citing CDC AtlasPlus)
• U.S. Preventive Services Task Force, syphilis infection screening recommendations (nonpregnant adults and adolescents at increased risk, and pregnant people)