Syphilis continues to disproportionately affect Two-Spirit, gay, bi, trans, and queer men and non-binary people in Canada. Penicillin G benzathine (Bicillin L-A) remains the first-line treatment for primary, secondary, early latent, and late latent syphilis. To reduce pain and support treatment adherence and retention, co-administration with lidocaine is a new and strongly encouraged practice. However this option is not widely available.
This guide outlines evidence-informed recommendations for reducing injection-related pain alongside affirming care and culturally safe approaches tailored to 2S/GBTQ+ communities.
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