I have only seen three cases of active syphilis in my career, despite working in an STD clinic for seven years. In Canada, that makes me an expert, because at home the infectious forms of syphilis are rare. Today, I saw a case of primary syphilis in a woman, something I have not seen before, a single painless genital ulcer. Syphilis is a bit like TB: it presents in many myriad forms, it is a very old disease that has shaped history and culture, and it affects marginalized and poor populations around the world.
Syphilis and other sexually transmitted infections accelerate the spread of HIV/AIDS. Inflammation and open sores, anything that interrupts the integrity of skin and mucous membranes, allows the HIV virus to gain entry into the body.
The prevalence of HIV/AIDS in southern Sudan is quite low in comparison to the surrounding countries. During the war, many people from southern Sudan fled to neighboring countries of Ethiopia, Kenya and Uganda, all countries that have higher rates of HIV than southern Sudan. Now that the peace accord between the north and south has been in place for more that two years, the Sudanese refugees are beginning to filter home. Migration of large groups of people is a potent catalyst for the spread of HIV/AIDS; I fear it bodes tragedy for the people of southern Sudan.