Silent epidemic: syphilis cases soar in West Midlands amid gaps in sexual health education

Between 2021 and 2023, studies measured the highest increase in England of syphilis cases in the West Midlands. Across just two years, the number of heterosexual men diagnosed with the sexually transmitted infection rose 149%, while the number of heterosexual women with the condition also rose by 121%. Although rates of syphilis remain the highest among gay and bisexual men, with 280 cases reported in 2023, the rise among heterosexual men from 75 to 187 has been the most surprising. Additionally, it can be passed on by pregnant women to their unborn children, causing significant disabilities if not treated, including blindness, brain damage, and bone deformities. Angela Cartwright, from the UK Health Security Agency (UKHSA), described the severe, irreversible long-term health effects untreated syphilis can cause:

People see it as a historical disease and don’t realise it’s really prevalent now…People also think it’s just young people who are affected, but much of the rise has been among those who are middle ages and older, who might not think they are susceptible.

– Angela Cartwright

Symptoms and support

Syphilis is a sexually transmitted infection that, when left untreated, can cause serious and potentially life-threatening problems. Its symptoms are often mild and hard to notice; they also tend to change over time and may come and go. Some of those symptoms may include:

• Small sores/ulcers on or around the genitals and mouth – these tend to be painless
• White or grey warty growths
• A rash on the palms of hands and feet that is not usually itchy but can spread all over the body
• White patches in the mouth
• Flu-like symptoms, such as a high temperature, headaches, and tiredness
• Swollen glands
• Patchy hair loss on the head, beard, and eyebrows

Having one or more of these symptoms doesn’t necessarily guarantee you have syphilis, or other sexually transmitted infections, however, it can be scary and overwhelming to decide to take an STI test, or make further treatment or professional consultation decisions. Luckily, at the University of Warwick’s Health Centre, all students have a wide range of services that cover many health issues and concerns which may impact a student’s sexual health. The Health Centre offers friendly, discreet, and confidential access to all students regardless of sexual orientation, gender, race, or disability.

Unfortunately, due to the need for certain tests to be processed quickly for a reliable result, the Health Centre is only able to offer a limited service at the campus site. They offer screenings for chlamydia and female swab-taking to detect Bacterial Vaginosis, Thrush, and some other non-sexually transmitted infections. For students living in Coventry, you can request a Chlamydia self-screening pack at the Health Centre’s reception which contains all the instructions needed and the result will then be either texted, posted, or emailed to you depending on your identified preference. For students living outside of Coventry, you can use the Google Freetest.me tool to find information about how to request a free home Chlamydia test. If you would like to have a full STI screen that can check for other infections such as Gonorrhoea or Trichomonas, you will need to visit a sexual health clinic (SHC) where they will also be able to complete blood tests for HIV and Syphilis at the same time. To find your local sexual health clinic, and to book an appointment or at-home STI tests, visit their website.

Prevention and education

Although daunting, syphilis is a preventable and curable infection. It is transmitted during oral, vaginal, and anal sex, in pregnancy, and through blood transfusion. The best way to prevent syphilis and many other STIs is using condoms consistently and correctly, especially if you are sexually active with different partners, or have just become sexually active with a new long-term partner. Syphilis can also spread through contact with other areas of the body not covered by a condom, therefore people at higher risk of infection should be tested at least once a year. Sexually transmitted infections can feel awkward, uncomfortable, and embarrassing to talk about, however, your health is so much more important than one or two short uncomfortable conversations.

It is simple and fast to book an appointment at Warwick’s Health Centre or your closest sexual health clinic, and all nurses are trained to make you as comfortable as possible during consultations and possible treatments. It is also possible to make requests before an appointment, whether for a female or male nurse, or for a family member or friend to be with you during the appointment, so make the most of these options to ensure you are as comfortable as possible. Ultimately, if in doubt, it is so much better to book a ten-minute appointment and have a consultation with a qualified nurse in a safe, non-judgemental zone, than risk potentially life-threatening consequences later in life. The discomfort and taboo nature surrounding STIs and discussion of them, as well as the often lack of inclusive and well-rounded education on sexual health, are some of the reasons they are so heavily on the rise.

Once the barriers of discomfort surrounding sexual health are broken down within schools at a younger age, young people will be more confident in practising safe sex and seeking medical support without embarrassment

Up until the age of sixteen, I had an entirely Catholic education. It was only when I moved to a non-religious sixth form and then to university, that I realised the limits this had placed on my knowledge of my body and the world, and my mental development as a young woman. I can confidently say that I have never had a sexual education class. It feels bizarre and shocking that the first time I saw a vulva diagram was at the age of sixteen in a biology class, in which I struggled greatly to label its parts. Prior to this, my only memory of any form of sexual education was at the age of eleven, when the girls were taken to a separate classroom to learn about menstruation, while the boys next door made paper aeroplanes. When it came to real-life experiences, I felt like I was trudging through no-man’s land with a blindfold on. With this lack of sexual education also came a lack of awareness with regard to sexual health. In the eyes of the Catholic schools I attended, their students were not sexually active and therefore not in need of STI or general health support. My educational experience came down heavily to religious influence – this is not to say that all religious schools are censored this heavily, nor does a lack of sexual health education only occur because of religion.

There is a lot of debate regarding at what age it is appropriate to begin sexual education in schools, and to what extent. Regardless of the answer to this question, I strongly believe that sexual education is in desperate need of improvement across the West Midlands and the rest of the UK. Sex is so much more than a simple biology lesson: it should be a truly inclusive course of teaching, including different types of sex, queer sex, pleasure, and most importantly, safety. Once the barriers of discomfort surrounding sexual health are broken down within schools at a younger age, young people will be more confident in practising safe sex and seeking medical support without embarrassment or hesitation when needed.

The rise in syphilis cases is concerning, and it affects students just as much as older people. Just under half of our age group are sexually active. Therefore, it is crucial we understand the risks and precautions when practising safe sex while still enjoying ourselves. Sexual health is not a taboo or embarrassing subject. One of the first steps we must take in reducing that number of infections, is de-stigmatising the entire conversation and making it a more open, safe topic to discuss with friends and family. The NHS and Warwick’s Health Centre offer lots of medical and emotional support regarding sexual health. Visit their website to find out more information on how to contact them and other local services available.