Syphilis rates in Ottawa rose again last year, continuing a trend Ottawa Public Health says is unlikely to change anytime soon.

Last year's preliminary estimates show as least 129 people in Ottawa contracted infectious syphilis. That's up from 100 cases in 2015 and 44 in 2014.

"We're definitely concerned," said Leslie Tilley, a nurse and Ottawa Public Health's supervisor of case management team in charge of sexually transmitted and bloodborne infections.

"This wasn't just a bad year or a one-off. This is a long-term trend that we're seeing."

Now, local groups are relying on a tactic that's being used with mixed success in jurisdictions across the continent — cheeky campaigns meant to raise eyebrows and lower risky sexual behaviour.

'Be bold,' says local advocate

By the 1950s, syphilis had been practically wiped out, but Tilley says health agencies in cities across North America are seeing a similar resurgence of the disease. Now, they're working together.

Ottawa Public Health is hoping its 'Your penis isn't the only thing that's on the rise' campaign, which it borrowed from San Francisco, will bring attention to the issue. (submitted by Ottawa Public Health) That's how Ottawa came to borrow its 'Your penis isn't the only thing that's on the rise' campaign, which originated in San Francisco's gay community.

"I think [these campaigns are] great," said David MacMillan, the men's outreach coordinator with the AIDS Committee of Ottawa. "It's important to be bold in your health promotion so that it catches people's eyes."

In fact, MacMillan says his organization is preparing to launch its own campaign, "The Sex You Want," complete with its own hashtag and posters featuring cartoon illustrations of couples cuddling in bed.

Rise of social media and syphilis

MacMillan says the rise of syphilis coincides to another major change in the LGBT community — the advent of popular gay hook-up apps, like Grindr and Scruff.

"[It's] happening because people are having sex more, because people have greater access to it through these apps," he said.

Furthermore, MacMillan says he's noticed an increase in the number of men who don't use condoms when they have oral or anal sex.

He suspects that's also connected to the uptick in casual and spur of the moment sexual encounters.

"It's a bit difficult if guys want to be discreet and negotiate condom use," he says.

MacMillan is not the only health advocate to make this somewhat controversial assertion, with some popular apps striking back against the idea.

Risks of syphilis severe

Syphilis is not difficult to treat, but symptoms change as the infection progresses — sometimes reaching a stage where there are no symptoms at all.

Both MacMillan and Tilley say that's why it's important to make people more comfortable talking to people — and especially healthcare providers — about sexually transmitted infections and testing.

With an increased presence at Pride events and more eye-catching campaigns, they say the word is spreading.

"The general population isn't aware that it's still out there," said Tilley, but for the most at-risk populations, "more testing for syphilis has occured."

Syphilis is still on the rise in Ottawa, with at least 129 cases reported in 2016. (Getty Images) Ottawa Public Health has a program to provide free medication to doctors and nurse practitioners, so that people who feel embarrassed about their diagnosis don't need to go to a pharmacy.

It's a great idea for people who find the conversation uncomfortable, agrees MacMillan.

Left untreated, syphilis can become serious affecting other parts of the body including the heart and brain. In some cases, it can even be fatal.

For people who have HIV, syphilis infections worsen far more quickly. Syphilis can also make that infection more difficult to treat.