Advocating for Comfort in Syphilis Treatment
Sexual health care should be effective, respectful, and as comfortable as possible. During Sexual Health Week, Prochoice YQL is sharing information to help patients understand their options and advocate for care that honours their bodies and experiences.
Syphilis continues to affect Two-Spirit, gay, bi, trans, and queer men and non-binary people at higher rates in Canada. Many people seeking treatment already navigate stigma, fear, or past negative healthcare experiences. Pain during treatment can make these experiences more difficult and can discourage people from returning for care or completing treatment.
The first-line treatment for syphilis in Canada is benzathine penicillin G, also known as Bicillin® L-A. This medication is highly effective and widely used. It is also known to be painful to inject because it is given as two intramuscular injections at the same appointment. For many patients, this pain is not minor and can feel overwhelming, especially when care settings feel rushed or impersonal.
Practice guidance shared by the Community-Based Research Centre (CBRC), highlights an option that patients can ask about when receiving syphilis treatment. Lidocaine, a local anesthetic, can be used alongside benzathine penicillin G to reduce injection-related pain. Lidocaine is compatible with the medication and can be administered at the same time. Evidence shows that using lidocaine can improve comfort during treatment.
Pain management is part of patient-centred and trauma-aware care. Reducing pain supports informed consent and trust between patients and providers. It can also make it easier for people to complete treatment and return for follow-up care when needed.
Patients have the right to ask questions about their treatment and to request care that reduces unnecessary discomfort. If you are preparing for syphilis treatment, it can help to think ahead about what you need to feel safer and more supported.
Questions you can ask your provider
You can ask your provider:
Whether lidocaine is available to help reduce pain during your syphilis treatment.
What steps they take to reduce injection pain and support your comfort.
A clear explanation of what the injection will feel like and how long the discomfort might last.
Extra time, privacy, or grounding support during treatment.
Share if you have anxiety, past medical trauma, or concerns about pain so your provider can better support you.
Asking these questions is part of informed consent. It does not make you difficult or demanding. It makes you an active participant in your care.
Bodily autonomy includes the right to care that minimizes harm. Sexual health care should support both physical health and emotional safety. Pain management is part of respectful, affirming, and accessible care.
We are grateful to CBRC for sharing this practice guidance and for continuing to advocate for equitable sexual health care for Two-Spirit, gay, bi, trans, and queer communities.
You deserve care that listens to you, respects your body, and supports your comfort. Advocating for pain management is a valid and important part of taking care of your sexual health.
