Outbreaks of syphilis affecting sex workers
UKHSA is working with colleagues in sexual health services and public health teams in several locations including Yorkshire and London to investigate outbreaks of syphilis associated with sex workers. These outbreaks, which have included cases of congenital syphilis, were identified locally by clinicians and multi-agency teams have been established to coordinate measures to support those affected by providing advice on prevention, testing and treatment.
Building on the excellent work being done in these local outbreaks, a national incident management team has been convened to coordinate actions on common issues arising including:
- Ensuring that we have an accurate picture of outbreaks of STIs affecting sex workers across the country
- Highlighting issues to commissioners of other services which sex workers may access to ensure appropriate support and signposting to sexual health services
- Working with sex worker-led and support organisations to develop messaging for sex workers about syphilis, covering:
- Advice about signs / symptoms
- Encouraging people to present for testing
- Reassurance about confidentiality of services
- Explaining reasons for disclosing status and sharing information if safe to do so – and that this is for public health actions, doesn’t affect treatment
- Advice about preventing transmission – including the option of doxyPEP
- While these resources have been tailored towards sex workers they do not explicitly target or refer to sex work to avoid stigma
- They will be typeset and formatted and made available as part of a suite of materials that can be used in future outbreaks/ incidents
Actions for sexual health clinics
- Please ensure that patients are correctly identified as sex workers in GUMCAD reporting - via data item ‘Patient_Type’ (see section 4.4 of the GUMCAD Clinical Coding Guidance)
- Discuss options regarding doxyPEP – in line with guidance which includes the option to offer to those at higher risk including sex workers. Link to the guidance - https://www.bashh.org/resources/141/doxycycline_postexposure_prophylaxis_2025
- If you have concerns about syphilis (or other STIs) affecting sex workers, please contact your local Health Protection Team and UKHSA Sexual Health Facilitator who will be able to support local investigations and, if necessary, convene an incident management team to coordinate actions needed to address the local situation.