For people living with HIV, co-infection with HIV and syphilis may complicate the treatment of both diseases. People with HIV may also be at higher risk for neurosyphilis. A person already infected with syphilis, who has sexual contact with another infected person, also infected runs the risk of an additional syphilis infection. Testing for syphilis at least every four to six months is suggested for sexually active people. Syphilis occurs in phases that may overlap, and do not always follow in the same sequence.
Symptoms vary with each phase.
In the primary phase, painless sores or open, wet chancres appear, often from three weeks to 90 days after infection. They last three to six weeks. They appear on the genitals, in the vagina, on the cervix, lips, mouth, or anus. Swollen glands may also occur during the primary phase. Other symptoms occur in the secondary phase, which begins between three and six weeks after the sores appear.