Is Syphilis still rising in heterosexual men? The latest figures

Syphilis is no longer rising in heterosexual men in England, but it hasn’t gone away. The UK Health Security Agency (UKHSA) publishes the figures each year. Here’s how 2025 compared with 2024:

These figures are for infectious Syphilis, which means the early stages of the infection, and they cover England only.

On top of these, there were 1,010 diagnoses of late-stage Syphilis or its complications in heterosexual men in 2025. Many of these are infections that weren’t found in the early stages.

Between 2015 and 2024, diagnoses of infectious Syphilis in England:

• more than doubled in heterosexual men, from 595 to 1,380
• tripled in heterosexual and bisexual women, from 273 to 830

A sharp jump in men came in 2024, when diagnoses rose by 24% in a year, from 1,115 to 1,380. Over the same year, diagnoses rose by 1.0% in heterosexual and bisexual women and fell by 1.6% in gay, bisexual and other men who have sex with men.

In 2024, more than 13,000 cases of Syphilis at any stage were diagnosed in England, the highest number since the 1940s. Almost 1 in 4 infectious Syphilis diagnoses that year (23%) was in a heterosexual man or woman.

UKHSA updates its figures every year, which is why the 2024 figure here (1,380) is slightly different from the one in the table above (1,352).

No one knows for certain. UKHSA says more insight is needed, but its reports point to a few things:

• it isn’t just more testing: heterosexual men had fewer Syphilis tests in 2024 than in 2015, yet the share of tests that came back positive rose from 0.14% to 0.35%
• low awareness: UKHSA says a lack of knowledge of Syphilis has been shown among heterosexual people, and there may be barriers to getting tested
• it’s spread across the country: in 2024, 31% of diagnoses in heterosexual men and women were in London, 13% in the West Midlands and 12% in the North West
• it’s linked to deprivation: 36% of diagnoses in heterosexual men and women were in people living in the most deprived fifth of areas, compared with 7% in the least deprived

Having one partner doesn’t rule it out. Among heterosexual men diagnosed with infectious Syphilis in 2025 who reported at least one recent partner, 54.9% had one sexual partner in the previous 3 months. This data is provisional, and partner numbers were recorded for about a third of clinic visits.

Most of the fall in 2025 was among gay, bisexual and other men who have sex with men, whose diagnoses dropped to their lowest level since 2016.

Since summer 2025, sexual health services in England have offered doxyPEP to gay and bisexual men and transgender women at higher risk of Syphilis. DoxyPEP is an antibiotic taken after sex that lowers the risk of catching Syphilis. UKHSA says some of the fall in this group may be down to doxyPEP, but it’s too early to tell.

Among heterosexual men, the fall was small. UKHSA describes the trend outside gay and bisexual men as relatively stable since mid 2024. In January to March 2026, there were 1,721 diagnoses of infectious Syphilis in England, down from 1,975 in the previous 3 months.

In March 2026, UKHSA published a Syphilis Response Plan for 2026 to 2029. It aims to raise awareness, strengthen prevention, improve testing and care, and stop Syphilis being passed on to babies in pregnancy.

It’s too early to say whether the fall will last.

Diagnoses in heterosexual and bisexual women rose by 4.8% in 2025, even as they fell in men. That matters because Syphilis can pass to a baby during pregnancy.

If it isn’t treated, Syphilis in pregnancy can cause miscarriage, stillbirth or serious health problems for the baby. In England, 13 babies were reported to have been born with Syphilis in 2023.

A blood test for Syphilis is offered in every pregnancy, ideally by 10 weeks, and you can ask for it again at any time during pregnancy. If your test is positive, your partner is offered a test too, so the infection isn’t passed back.

Syphilis is usually passed on through close contact with a Syphilis sore during vaginal, anal or oral sex without a condom. The sores can be on the penis, vagina or bottom, or inside the mouth. They’re usually painless, so they’re easy to miss.

It can also be passed on:

• to a baby during pregnancy
• by injecting drugs with a needle that’s been used by someone with Syphilis
• rarely, through a blood or organ transplant, although all donations in the UK are checked for Syphilis

UK guidelines say about a third of the sexual partners of someone with infectious Syphilis catch it. Condoms lower the risk, but a sore on skin the condom doesn’t cover can still pass it on. Read more in “Can you pass on Syphilis without a sore?”

It can take 3 weeks or more for the first symptoms to appear, and they’re often mild and hard to notice. Symptoms of Syphilis include:

• small sores (ulcers) on your penis, vagina or around your bottom, which are usually painless
• sores in other places, such as your mouth or lips
• a rash on the palms of your hands and soles of your feet, which isn’t usually itchy
• white or grey warty growths, usually on your penis, vagina or around your anus
• white patches in your mouth
• flu-like symptoms, such as a high temperature, headaches and tiredness
• swollen glands
• patchy hair loss on your head, beard and eyebrows

The symptoms can go away on their own, but the infection stays in your body until it’s treated. Without treatment, Syphilis can cause serious problems with the heart, brain, nerves and other organs many years later. UK guidelines say this happens in about a third of people who aren’t treated. Read more in “What does a Syphilis sore look like?”

UKHSA recommends testing if you’ve had sex without a condom with a new or casual partner in the last 3 months, or if a partner has tested positive for an STI. That applies whatever your age, gender or sexual orientation.

A blood test can miss a very recent infection. UK guidelines say a negative result in the first 3 months can’t rule out early Syphilis, and recommend a repeat test 3 months after a risk.

If you have a sore, don’t wait. See a doctor straight away. A swab of the sore can find Syphilis before a blood test turns positive. Read more in “Can you have Syphilis and not know it?”

Syphilis is treated with antibiotics. UK guidelines recommend:

• early Syphilis: a single injection of penicillin
• Syphilis that’s been there longer: an injection once a week for 3 weeks
• if penicillin isn’t suitable: other antibiotics, such as doxycycline tablets

Don’t have sex until 2 weeks after you and your partner have finished treatment. You’ll have follow-up blood tests at 3, 6 and 12 months to check the treatment has worked.

Recent partners need to be told so they can be tested and treated. Depending on the stage of your infection, that can mean partners from the last 3 months or from up to 2 years ago.

Syphilis is curable, but having it once doesn’t protect you from catching it again. Read more in “Can Syphilis be fully cured?”

Better2Know offers:

• Syphilis: a blood test for Syphilis antibodies from 9 days after sex, with results in 1 day. You can book it at one of our clinics, have a nurse visit you, or order a home test kit.
• Peace of Mind: tests for Chlamydia, Gonorrhoea and Syphilis from 14 days after sex, with results in 2 days.
• Full Screen: tests for 7 infections, including Syphilis and HIV, from 28 days after sex, with results in 3 days.
• Blemish Screen: if you have a sore or growth, it tests a swab for Syphilis, Herpes 1, Herpes 2 and HPV, with results in 5 days.

If you test before 45 days, a negative HIV result needs a repeat test. A Syphilis test in the first 3 months after sex can miss the infection, so you may need a repeat test. Not sure which test you need? Our Patient Care Team is available 24/7 on 020 7099 0955.

Are these figures for the whole UK?

No. They’re published by the UK Health Security Agency and cover England only.

Can you have Syphilis without knowing?

Yes. The symptoms are often mild, the sores are usually painless, and symptoms can go away while the infection stays in your body. A test is the only way to know.

Is doxyPEP an option for heterosexual men?

UK guidelines recommend doxyPEP for gay, bisexual and other men who have sex with men and transgender women at higher risk of Syphilis. They make no recommendation for heterosexual men.

Syphilis is no longer rising in heterosexual men in England as it was in 2024, but diagnoses are still far higher than a decade ago, and they rose again in heterosexual and bisexual women in 2025. It’s easy to miss and simple to treat once it’s found, so if you’ve had sex without a condom with a new or casual partner, a test is the only way to know.

Book a Syphilis test at a clinic near you or order a home test kit. If your result is positive, a Better2Know doctor can help you get the treatment you need. Our Patient Care Team is available 24/7 on 020 7099 0955.

Not in the UK? Choose your country from the selector at the top of the page for local tests and prices.

This article originally appeared on 6 June 2025 and was last updated on 3 October 2026.

Medical review. This article was medically reviewed by Dr Steve Chapman, Doctor with a wealth of clinical experience in the field of STIs, on 4 August 2025. It is general information and not a substitute for personal medical advice.

Sources

1. UK Health Security Agency, Sexually transmitted infections and screening for chlamydia in England: 2025 report, 2 June 2026. https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables/sexually-transmitted-infections-and-screening-for-chlamydia-in-england-2025-report
2. UK Health Security Agency, STIs fall with syphilis among gay and bisexual men lowest in a decade, 2 June 2026. https://www.gov.uk/government/news/stis-fall-with-syphilis-among-gay-and-bisexual-men-lowest-in-a-decade
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8. British Association for Sexual Health and HIV, UK guidelines for the management of syphilis, 2024. https://www.bashh.org/_userfiles/pages/files/syphilis_2024.pdf
9. British Association for Sexual Health and HIV, UK national guideline for the use of doxycycline post-exposure prophylaxis (DoxyPEP) for the prevention of syphilis, 2025. https://www.bashh.org/_userfiles/pages/files/saundersetal2025britishassociationforsexualhealthandhivbashhuknationalguidelinefortheuseof.pdf
10. World Health Organization, Syphilis, 29 May 2025. https://www.who.int/news-room/fact-sheets/detail/syphilis
11. British HIV Association, British Association for Sexual Health and HIV and British Infection Association, Adult HIV testing guidelines, 2020. https://bhiva.org/wp-content/uploads/2024/10/HIV-testing-guidelines-2020.pdf