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October 05, 2012 08:00pm
Answers from the CDC
Source: Letters to the Editor
by: Kora Peters

Steve,

Hey sugar, how are you? I hope you are well. I got some answers from the CDC about syphilis. It seems 2 different tests are needed to properly diagnose syphilis! http://www.korapetersblog.com/kp/

Kisses,
Kora

Constituent questions and responses.

1. What do you all think about the Trep-Sure Anti-Treponema EIA Screen test? It is what the adult industry is using to diagnose recent or current syphilis infections. I have read the product insert and it says on page 6 "A negative sample and/or the negative control will have an index value < 0.8. A negative result indicates that no, or very low levels of antibody are present in the sample, but does not rule out a recent or current infection." the "Does not rule out a recent or current infection," part really scares me! I fear that performers have gone back to work only to spread the disease further and possibly cause antibacterial resistant strains if they continue down this path.

To know whether or not someone currently has syphilis, two kinds of blood tests are necessary. A "non-treponemal" test (like an RPR) is not specific for syphilis, but if someone has syphilis, the number value of the test ("titer") will tell how active the infection is. A "treponemal" test (like the EIA) is specific for syphilis, but once someone has syphilis, they will always be positive.

CDC recommends testing with a non-treponemal test first, and if positive, then testing with a treponemal test. While some facilities test with a treponemal test first, understanding what that result can be difficult.

CDC cannot comment with confidence unless we know more about the specific testing and case. If you are concerned, we suggest you discuss this with your physician to determine the appropriate tests for you.

2. Is there a chance of reinfection with syphilis if sexual intercourse begins with multiple partners 14 days after taking antibiotics?

Syphilis may enter a latent stage when transmission is less likely and remain that way for years. However, infectious syphilis may recur at any point though it is more likely to happen closer to the time of original infection. It is possible for a person to have infectious syphilis without knowing it. Sores can occur in difficult to see areas and are usually painless, and rashes may be light and not easy to identify.

An individual with syphilis should abstain from sexual contact until their sores heal.

See information about reinfection here: http://www.cdc.gov/std/syphilis/STDFact- Syphilis.htm

3. Since everyone in the industry takes so many antibiotics and a large number of them have been treated for gonorrhea at least once if not several times will one shot of penicillin [per person] be enough to treat a syphilis outbreak? They worked during the moratorium, only 300 performers were given antibiotic shots (whether or not they had syphilis) and they are using a test that doesn't diagnose "recent or current infections".

Syphilis and other STDs like gonorrhea and chlamydia are treated with different drugs: The appropriate antibiotic must be used for the appropriate infection. Penicillin is the treatment of choice for syphilis, but will not treat gonorrhea, and the drugs used to treat gonorrhea will not work for syphilis

If syphilis is treated within one year of infection, a single dose of penicillin (2.4 million units of benzathine penicillin) will cure infection. After one year of infection, three doses of penicillin are used.

4. Is it safe to be filming now with only 300 performers [total number of performers not being provided] being treated for syphilis (whether or not they had it)?

Any unprotected sexual contact carries with it the risk of infection with an STD. That risk can be decreased by using a new condom with each sexual act. Not knowing when and how people were treated makes this question difficult to answer.

5. Will one shot kill syphilis in these people who are antibiotic resistant? There is only one treatment left for gonorrhea because of behavior like this; are we going to do the same to syphilis if we continue down this road?

While treatment failure with penicillin has occurred, penicillin resistance has never been documented with syphilis. If syphilis is treated within one year of infection, a single dose of penicillin (2.4 million units of benzathine penicillin) will cure infection. After one year of infection, three doses of penicillin are used.

See syphilis treatment guidelines: http://www.cdc.gov/std/treatment/2010/genital-ulcers.htm#syphilis

6. …There seems to be this theory in the industry that you can take a shot of penicillin as a preventative treatment for syphilis. To me that seems absurd but they are eating it up as quickly as they are being fed this Bs.

CDC does not have data to support this theory. Treatment for syphilis does not provide protection against gonorrhea, chlamydia, herpes, HIV, or a host of other STDs – all of which are transmissible with unprotected sexual contact. Again, to reduce the risk of infection with an STD during sexual contact, a new condom should be used with each sexual act.

7. Performers believe they are safe now and that one test is sufficient for a proper diagnosis of syphilis. I thought it takes two tests to properly diagnose...am I correct?

To know whether or not someone currently has syphilis, two kinds of blood tests are necessary. A "non-treponemal" test (like an RPR) is not specific for syphilis, but if someone has syphilis, the number value of the test ("titer") will tell how active the infection is. A "treponemal" test (like the EIA) is specific for syphilis, but once someone has syphilis, they will always be positive.

CDC recommends testing with a non-treponemal test first, and if positive, then testing with a treponemal test. While some facilities test with a treponemal test first, understanding what that result means can be difficult.

Having an open, honest conversation with your medical provider is the key to ensuring that you receive the examination, testing, and treatment needed to address your concerns. A resource for having that conversation: http://www.itsyoursexlife.com/gyt/talk/talking-to-your-provider/

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