 Syphilis was very common in Europe during the 18th and 19th centuries . Flaubert found it universal among nineteenth @-@ century Egyptian prostitutes . In the developed world during the early 20th century , infections declined rapidly with the widespread use of antibiotics , until the 1980s and 1990s . Since 2000 , rates of syphilis have been increasing in the USA , Canada , the UK , Australia and Europe , primarily among men who have sex with men . Rates of syphilis among American women have remained stable during this time , and rates among UK women have increased , but at a rate less than that of men . Increased rates among heterosexuals have occurred in China and Russia since the 1990s . This has been attributed to unsafe sexual practices , such as sexual promiscuity , prostitution , and decreasing use of barrier protection . 
