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When and How to test for Syphilis

Syphilis Test

Phew. Finally found the time to sit down and pen this long awaited entry. I have been getting questions about Syphilis testing and would like to set the record straight.

 

Syphilis Symptoms

First of all a few basic facts. Syphilis is a bacteria. It is transmitted via direct skin contact with contagious Syphilitic lesions. What are considered contagious Syphilitic lesions you say? Well, they are ulcers caused by Syphilis (known as a Chancres) and the skin rash that occurs in secondary Syphilis. The ulcers are generally single and painless (except in HIV positive patients where the ulcers can be multiple and painful). They can appear anytime between 9 to 90 days post infection. Most commonly they appear at about 4 weeks post infection. The ulcers are found at the site of bacterial entry. So they can be anywhere but they are most frequently found in the anogenital region. The rash caused by secondary Syphilis is called the Great Imitator because it can look like any rash. It appears 3 to 6 weeks after the initial Syphilitic ulcer (Chancre) has subsided. Since it can look like anything, it is hard to differentiate from other rashes (eg eczema). It is usually a macula-papular rash that involves the trunk more than the limbs and also involves the palms and soles.

At this point some of you are asking ‘If what you say is true, then Syphilis is not necessarily sexually transmitted.’ To that I say ‘You are absolutely right.’ There was a user on the forum (www.askdrtan.com) who caught Syphilis from her client. She is a masseuse. Direct skin contact with infectious lesions remember?

 

Syphilis Stages

Next I want to clear up some technical terms. Often people throw words at me like ‘Early Primary Syphilis’ and ‘Latent Secondary Syphilis’. This shows that there is a lot of confusion in the terminology out there. So let’s set the record straight.

There are 2 stages of Syphilis: Early and Late. The definition of early Syphilis VARIES depending on which guidelines you read. According to the US CDC, if the Syphilis infection was within the past 1 year, it is considered Early Syphilis. According to the WHO it is 2 years. Why does this matter? It determines what treatment a patient gets. Early Sypphilis requires less medicines than Late Syphilis. So far confusing enough? It gets worse.

Early Syphilis is divided into 3 clinical stages. Primary Syphilis, Secondary Syphilis and Latent Syphilis (also known as Early Latent Syphilis). The stages are characterized as such: Primary Syphilis – presence of Chancre, Secondary Syphlis – presence of rash, Latent Syphilis – no symptoms.

Late Syphilis is divided into 2 clinical stages. Tertiary Syphilis and Latent Syphilis (also known as Late Latent Syphilis). The stages are characterized as such: Tertiary Syphilis – End organ involvement including aneurysms, Latent Syphilis – no symptoms.

There are 2 other types of Syphilis we will not be discussing in this post and they are Neuro-Syphilis (Syphilis involving the nervous system) and Syphilis in the Newborn.

 

Syphilis Tests

Remember we said Syphilis is a bacteria? To be more precise, Syphilis is the disease caused by a bacteria and this bacteria is called Treponema Pallidum. The special thing about T. Pallidum is that it cannot be cultured. In other words, you cannot grow it in a dish. The only way to prove it is there is either to see the live bacteria directly or by using indirect evidence of its presence (something known as serology tests which are essentially blood tests).

To see the live bacteria you first need an active lesion. Next, you need a skilled person to sample bacteria from the lesion. Next you need special equipment and specially trained medical professionals to use this special equipment to look for the bacteria. Because the case load of Syphilis for most countries is rather low, most labs either do not have the equipment or the training. Also, because if the high rate of false negatives from these tests, patients suspected of Syphilis are required to follow up with serology testing anyway. In other words, these tests are rather useless except in very specific settings.

Serology tests are the mainstay of diagnosing Syphilis. There are basically 2 types of serology tests: Treponemal Tests and Non-Treponemal tests. There are many types of Treponemal Tests (eg TPHA, FTA-Abs etc). There are also many types of Non-Treponemal tests (VDRL, RPR, HEAT etc). For ease of discussion we will consider all Treponemal tests the same and all Non-Treponemal tests the same.

The one very important thing to remember is that there is no such thing as one perfect ‘most accurate’ test for Syphilis. This is what most people look for and it is really just chasing a rainbow.

 

Treponemal tests are very good at screening for Syphilis. They are as good as 100% accurate in diagnosing Syphilis except under 3 conditions. The first is very early Syphilis. When I say very early I mean less than 12 weeks from the date of infection. Although Treponemal tests are as good as conclusive at 4 weeks, the recommendation is still to retest at 12 weeks. The second is very late latent Syphilis. How late? Nobody knows. The accuracy of Treponemal tests is late latent Syphilis drops from 100% to 97% over several years. The third and last condition under which Treponemal tests are of no use is if a person has been previously infected with Syphilis. Even if this person has been treated successfully, the Treponemal test will still remain positive. So there is no way to know if this person has been re-infected or not using Treponemal tests.

 

Non-Treponemal tests are often used for screening of Syphilis in places where the prevalence of Syphilis is relatively high. This is because of the third reason given in the preceding paragraph. (Also because it is cheaper). So you would notice that European Guidelines recommend using Treponemal tests for screening and most Asian guidelines recommend using Non-Treponemal tests. On the whole, Non-Treponemal tests are LESS ACCURATE than Treponemal tests when used for screenig of Syphilis. They are however useful under 2 conditions. The first is when a person has been previously infected with Syphilis and we need to find out if he or she has been re-infected or not. The second is for monitoring of treatment success or failure.

So remember we said there is no one perfect test for screening of Syphilis? The trick is to do both a Treponemal as well as a Non-Treponemal test for patients. That is ideal.

If a patient has never had Syphilis before, which would be the majority of readers here, and you HAD to choose one test, than the Treponemal test is better. Remember to always test at 4 weeks and retest at 12 weeks.

I hope that added some clarity to Syphilis testing.

I would like to end off on the note that nothing in Medicine is straightforward. Just when you think you had a handle on Syphilis testing, let me tell you this: All the above serology tests mentioned above will also be POSITIVE if a person has any of the Non-Syphilitic Treponemal Diseases. You didn’t think Syphilis was an only child did you? There are other bacteria under the Treponemal family which will all test positive using the exact same tests as we use to diagnose Syphilis.

So after all this discussion, we come back to square one. The same usual boring advice I give everyone.

Do not try to be your own doctor by reading the internet. If you want to know whether you have been infected with Syphilis or not, please Our Doctors trained in such matters and heed his advice.
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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191 Comments

  1. zack Zain

    Hi recently i went to massage parlour 4 times. Just to check if syphillis or hpv can be passed thru:

    1) handjobs

    2) touch/lick boobs

    Above all, NO sex or oral at all.

  2. Hello doctor,
    I was tested for HIV and along with TPHA in September. My TPHA came out to be negative. But while reading about syphillis I remembered that I had developed a painful ulcer like rash near my penis back in January 2017. Is it possible that the tpha result was wrong because I was tested after so long? How accurate is the test in such cases?
    Thank you.

  3. Hi Doctor

    can Syphilis transmit by handshake or casual contact of infected person’s hand with bare back/arms of uninfected person?

  4. Hi Dr

    I contracted syphilis about 49 years ago, was treated with antibiotics by a doctor, who layer pronounced me free of the disease.It has not recurred.
    I would now like to donate blood (in the UK). I know my blood will be tested in advance to see if it is suitable for donation.
    Could you advise me, please, what the results are likely to be? (I have read that there might still be some antibodies in my blood, which might mean I could not be a blood donor.

    Thanks
    7 November 2017

    • It depends what kind of testing they will do, but yes the tests may still come back as positive – using VDRL/RPR, if titres are 1:1 or 1:2 we can consider this serological scarring. Please speak to your doctor in the UK for further information.

  5. Hi Dr,
    I Made an unprotected oral sex with a lady 4 week before. 5 days after I got flue along with cough and white sore in my mouth. Exact at 3rd week I consult a physician and as per his instruction, I made VDRL (RPR)test, CRP test & CBC test. The result came like that my WBC count came above normal, Differential leukocyte count came as normal, VDRL test came non reactive and C Reactive Protein Tes came as positive.
    After this result, my physician conclude that these symptoms are because of some bacterial infection & not because of HIV infection. He give me some antibiotics to recover from this symptoms.

    But still I have cough and two white spots in my mouth….

    Do I need to worry????
    Is there any chance for HIV infection???

    Can I conclude this test as final???

    • There is no way from your tests I can conclude any information about your HIV status, other than to say I do not believe you are even at risk from oral sex.

      • Hi doctor,
        Hi dr,

        Thanks for your reply.
        I have some more queries.
        Once I get relive from cough, I feel a mild pain on the bottom of my feet. After few days I got affected with hives (which I had before the exposure also but this time sevierty of hives is high). I am very much worried.
        Is there any possibility to show HIV symptoms one by one?
        Did my symptoms are related to HIV?

        • Like I said, symptoms are non-specific for HIV so I cannot diagnose or exclude HIV just from symptoms. The only way you would know is by testing. Other than that, I have also said your risk is close to zero.

      • Doctor,

        I visited your clinic on 9th Oct following a possible exposure on 9th Sept.

        I was tested negative for Gen 4 HIV/Syphilis test. Prior to that, I was on 2weeks doxycycline (15-28 Sept) for a separate condition.

        May I know how conclusive are the test results and if I need to return for further testing? If so, when is the earliest I can get tested for a conclusive results.

        Thank you, Doctor.

        • Your HIV results would be conclusive; for syphilis, although a test at 1 month is a very good indication, I would recommend a repeat test at 3 months if you are still concerned.

  6. Gabe Siaulys

    What happens if I get treated for very early syphilis (one penicillin shot) even before the RPR result has a chance to become reactive? Will it become reactive after said treatment with decreasing titers afterwards or it will it not become reactive at all?

    • It can be difficult to detect in this situation, but you would best repeat testing including treponemal-type as it may be more sensitive.

  7. Anthony

    Hi,

    Is it correct to say that someone without the active lesion would not transmit syphillis ? For example, without the cancres, hashes or if it’s in the tertiary stage ?

  8. Dr, I’m from Malaysia, with syphilis in my recent blood test report. Am I able to obtain a Work Permit in SG? or I will be banned for whole life to work in Singapore?

    • It depends which work permit you require, but most will test for syphilis. You will need to have your syphilis treated before applying to work in Singapore. You will not be banned for life.

  9. Hi Doc,

    I recently met a person who had syphilis, but had treatment at the time I met him (he didn’t get his updated results). We didn’t have sex or kiss, but we sat next to each other and our arms were involuntarily bumping onto one another. I later noticed on his arm that there were red bumps and it alarmed me.

    I got tested 1 month and 8 days after my possible exposure with him. My blood was drawn and my results came out negative. Would this be an accurate result considering the time frame I was tested and how I was possibly exposed to syphilis?

    Thanks

  10. Hi Dr,

    Male here received brief unprotected oral from a masseuse. till date 24 days post exposure, no symptoms.

    Read post and saw recommended test and retest at 4wks and 12wks respectively.

    if 4 wks test negative, are tests conclusive? im thinking of retest at 8wks too. is that necessary?

    Appreciate your advice, thanks!

    • For syphilis, a negative test at 4 weeks is a good indication but not conclusive. At 8 weeks it is much more sensitive, but 12 weeks would be 100% conclusive.

      • Thanks Dr.

        Judging from my situation, with the only exposure being unprotected oral and brief.. what would u think about the overall risk of a syphilis infection?

        i’m a little worried here.

  11. If women i had unprotected sex syphills kit test negative on 40 days. Mine 38day vdrl tpha laboratory test is negative. If women doesnot have syphills can i get it. No symtom.

  12. Hi Dr,

    I had prior Syphilis infection which had been treated 5 months ago and I suspect that I had been exposed to Syphilis again recently through unprotected oral sex. I saw that only nontreponemal tests ie. RPR can be done to test for reinfection. Can the doctor be able to differentiate between the previous infection and reinfection if the test was done 3-4 weeks post suspected exposure? If not, how long should I wait before testing for the results to be conclusive?

    • It can be difficult to differentiate reinfection at this point. I would suggest that if the risk of exposure was high (i.e. your partner had a confirmed syphilis infection) that you speak to your doctor to get empirical treatment. Otherwise, you would have to wait at least 3 months to repeat your titre levels and monitor for any increase.

  13. bettertocheck

    doc, i tested on 90 days after last exposure. really need your expert advise below here. Great if you can help to answer.

    1. Is my test conclusive?
    2. Any case that within 3 months become latent stage and unable to detect any of the bacteria?
    3. Can food transmit syphilis/HIV? Past few days i seen a chef with rash on one of his hand. Not sure it’s STD or what, and i’m paranoid after eating his food.

  14. Hi Doc,

    Recently i tested that i had TPHA positive & VDRL Reactive (1:1).
    Before the blood test, i have taken Amoxicilin 250mg for my sorethroat treatment.
    1) May i know will this antibiotic will cause my result become false positive?
    2) Should i retest or proceed for the treatment?

    Would appreciate if you could advise me what to do?

    P/S: i have syphilis at about 6 to 7 years back and has been cured by a proper treatment. I remember my last result also 1:1

    Thank You.

    Regards
    KK

    • It is likely just serologic scarring from past infection and I do not believe treatment is required. However, please discuss this with your doctor.

  15. Prashad

    Hi I had unprotected oral sex with a lady. 4 days later I noticed a weird patch on my penis, like a raised bump but very odd texture, similar to a sponge. This is only a few mm across, it’s tiny. I know I have to get tested but please in your opinion, could this be a symptom of syphilis and is it usual for a side effect to occur so rapidly after the sex act?

    • It is not usual to get symptoms so soon after exposure. However, we would be unable to tell without a proper examination. Please see a doctor for assessment.

  16. Arshad

    Hello Sir

    I am a male. i had protected oral sex with a female. i took Trep.pall. CMIA and VDRL for syphilis screening at exactly 5 weeks. Both tests came negative. I took cefuroxim 500 mg twice daily for throat infection for seven days starting at 17 day post above oral sex encounter. Are my syphilis tests conclusive? Did antibiotic might alter the tests result?

    • I would say your tests are as good as conclusive, but guidelines will still recommend repeat testing at 3 months post-exposure for 100% sensitivity.

  17. Hey sir!

    Can get your comments?

    I’m taking Unasyn Sultamicillin 375gm as prescribed by doc due to throat infection.

    If i take syphilis test and gonorrhea later on, will this medicine affect the blood test results? Making a flase positive or negative?

    My doc can’t tell me exact answer, would preferable your comments for this.

    • Yes, there is a possibility that antibiotic may affect the results, but we cannot predict the likelihood.

      • Thank you for your time to respond.

        I had tested for syphilis on 5th week, 7th week and 10th week. All came back negative.

        If i test at 12th week, any concern i need to take?

        Seriously need your advice here. Thanks ahead

        • I do not believe you require any further syphilis testing.

          • Again thanks for your quick response, Doc.

            last question before ending conversation just for confirmation purpose.

            As mentioned earlier, my test 5th week (Alere rapid test kit), 7th week (RPR & TPPA Lab test) & 10th week (Alere rapid test kit) all negative.. should i retest again at 90 days? Conclusive by now? Any possible they provide false negative?

            Appreciate if you could help to answer.

          • I do not believe you require further testing.

          • AGAIN THANKS FOR YOUR REPLY DOC.

            JUST NEED AN ANSWER FOR FUTURE TEST. HOW SOON & ACCURATE CAN WE TEST FOR SYPHILIS?

            CAN SYPHILIS CAUSE TONSILITIS?

          • Syphilis can cause many symptoms, but I would not say tonsillitis is typical. You can detect 99% of syphilis cases at 6 weeks post-exposure.

          • Doc, just a quick one. Syphilis skin rash is contagious, correct?

            How about just little little round spot skin peeling off (less than 1cm? No lesions, no fluid coming out, no bleed.

            Just need your advice soonest here.

  18. Sorry to ask

    Does any vitamin supplements affect the syphilis blood test results?

    And will i endanger my family if live together?

    Any precaution i should take if I’m positive?

    • No, vitamins will not change anything. It does not endanger your family. There are no particular precautions I would take other than to abstain from sex from your partner until you have completed treatment.

      • Sorry to ask

        Got it doctor.

        Anyhow can u help me to understand more? How will be the primary & secondary symptoms looks like? more than 1 cm?

        I really need to understand more. doc that i approach earlier was unable to identify.

      • Sorry to ask

        I have syphilis rapid test kit by Alere by 10th week exposure and it cames back negative..

        Can i assure it won’t become positive on later on? Although i knew it will have rare instances shows antibody on 3 months mark..

        Based on your medical knowledge, i need your advice

  19. Advice

    Doctor

    Can you advice what rarely cases syphilis only start to have antibody as late as 3 months?

    I tested around 2 months after exposure and negative. Rpr vdlr tppa

    I saw some article mentioned HIV antibody can be delayed to produce due to some rare cases such as organ transplant, chemotheraphy..

    How about syphilis?

    I can’t stop worrying.

    • You should stop worrying. Your test is very indicative. There is no way to know if your antibodies will take up to 3 months to appear – it can just happen. But there is no point being anxious. Just move on with your life and repeat your test at a later date for conclusive results.

  20. NeedDocAdvice

    Doc.

    I done RPR, VDLR and TPPA at 49 days exposure cames back non reactive. At 61 days im experiencing pain ulcer at lips.

    Can you advice onto this?

  21. I am afraid of having a test in syphilis because i have a tb and my treatment will end this thursday, can i get false positive in hiv and syphilis even if i am almost done in treating my tb ? 🙁 need help dr tan

    • It is still possible to get false positives test from TB antibodies which may cross-react.

      • My chest x-ray is completely ok of having tb and now taking vitamins to get better, can i know be test for syphilis and hiv ? Can it still cause false positive ? Or how long should i wait to get the true result of test ?

  22. johnson

    will a chancre go away on its own without treatment? if so, how long?

  23. Is it possible to have a chancre and still test negative with RPR. I was tested 4 weeks after having protected felatio from a sex worker. I do have a sore on penis at this time but tests returned negative / non-reactive..

    • Yes, you can have a primary syphilitic chancre with a negative RPR. You may opt for a treponemal test which can turn positive earlier in the course of the disease, but may still be negative nonetheless. Please come down to our clinics for a consult and evaluation if you are concerned.

  24. Hi Dr Tan,

    I did the STD test at your clinic, 16th Mar 2017 after 2 weeks oral sex. As you mentioned that all was cleared and dont need to retest. On the 3rd weeks, I had rashes and it was viral infection. Even since then, my body temperature has been ranged 37.3 to 37.5 most of the time and at times, it was 37.6, via ear.

    Is there any test that can determine the cause of the temperature?

    • drtan

      Of course there is. It depends on what we think is causing it. Dengue? Malaria? Common cold? Glandular fever?

      Come and let our doctor analyze your symptoms and recommend the appropriate test.

      • Likely this Friday morning or late morning. Now like additional symptoms – heavy head or headache.

  25. worrysomuch

    Hi, doctor,
    I am so worried, no idea whether got Syphilis or HIV or neither. Please kindly help me !
    I had sex with one sex worder on 14-March. I wear condom, used lubricant on my genitals, no breakouts on condom. That should be protected sex, right?
    But when I had sex with another sex worker this morning 29-March, I find some ulcers or sores on my back. That is strange, because I have no ulcers on the penis, anal or any other genital areas until now. I have no symptoms such as flu, cough or swollen neck.
    I have no idea whether I got Syphilis after the first sex 14 days ago. If so, I might get HIV this time, because I heard that HIV virus may invade through ulcers on the body skin, right?
    Since the time window for Syphilis and HIV are 4 weeks, should I have a screening test this week?
    Thank you very much !

    • Yes you can however you may need to have the tests repeated. Please consult your doctor.

  26. Dear Dr,
    I had a full STD test done recently and found that VD(syphilis TP Ab) is reactive, where as, VD(RPR) and TPPA are non-reactive. I have no history of syphils. But Doctor mentioned that it can be a late infection. He also said that no need to worry about. As a precautionary measure, Doctor given me oral antibiotic.
    The test was done 4-5 weeks after exposure.
    Some articles tells that, there can be many reasons for active TP Ab. I need your advise on this.

    • The possible causes of positive Treponemal test and a negative non treponemal test are :
      1) Very early syphilis infection
      2) Late latent syphilis infection
      3) Serologic scarring
      4) Non Syphillitic Treponemal infection
      5) False positive
      You should be followed up by your doctor

      please note that we are unable to verify the accuracy for your test. for that, please ask the doctor who has done the test for you.

      • Hi Doctor,
        Thanks for your reply.
        In this case, VDRL (TpAb) is a Non treponemel test which was only showing reactive. But RPR, the nontreponemel test is non reactive. Also, Treponemel test TPPA is also non reactive.

        your reply state vise versa on the type of tests.
        Appreciate your review. Thanks in advance.

  27. Hi Dr.Tan
    My first exposure happened in Apirl 2015, and the other exposure was in December 2015, I tested for both RPR and TPPA in January 2016,37 days after the last exposure,and get both negative results.After that,I was still concerned about it ,went for another TPHA test in early June 2016,still negative.

    Here’s my questions.
    1.Are these results conclusive saying that I am not infected?

    2.I saw some views that TPHA alone cannot completely eliminate the possibility, so I am worried about the accuracy about my second test.

    3.Ultimately, do I need further tests?

    Thank you .

    • I am sorry, this site is not for giving medical advice. You should see a doctor and get formal medical advice on Syphilis testing.

      As I mentioned in the article, I feel Syphilis screening should be done on both Treponemal and non-Treponemal tests.

  28. Hi,
    Had a massage more than a month ago. No sexual contact but it’s a gay massage parlour. Noticed some red spots on my back last week, they probably are pimples. Should i go for a checkup for syphilis for clarity of mind and what’s the usual cost to do a test?

    Thanks.

  29. John Doe

    Hello I am freaking out here and I am very scared. I for an rpr test done for syphllis at 17 days past exposure. It came back as non-reactive. It was oral sex both giving and recieiving. I had an oral exam of my thoart and it checked out ok. My partner went to the dr, got tested and came back negative on Oct 10th. We fooled around on 9/23/2016 Should I still be so worried. I am showing no syptoymns and now it has been 26 days.

  30. Hai Dor..i recently had a handjob with a massage girl..am i at risk of contracting syphilis?

  31. I will be visiting SNG and would like to do perform a std test. Suspect infected with syphilis. How long does it take before test result is knows. If treatment with injection is needed how many consultations are needed ?

  32. Hi
    I’m 24 years old. I have syphylis. The doctor prescribed me doxycycline (100mg twice a day for 15 days). Before treatment I made blood tests, this is results (before treatment):
    VDRL 1/2
    FTA 1/450
    TPHA 1/5120
    FTA-ABS positive

    PS: I don’t remember any symptoms. And I finish taking doxycycycline.

    1. What stage of syphylis is?
    2. What does it mean high value TPHA 1/5120 and another are low?
    3. Whether the treatment doxycycline for 15 days will be effective in this case?

    • Stanley, please direct these questions to your doctor. We cannot give medical advice or result interpretation over the internet. All I can say is, doxycycline is a suitable treatment for syphilis, usually given for patients with penicillin allergy.

  33. Doctor I am a 35 years old married woman. 3 months ago I had a health screen and got the report recently surprised me by showing STD result that both syphilis antibody and TPHA reactive! It further indicated RPR 1:1 weak reactive. Report result describing in this way” this indicate you may have history of previous treated syphilis If this has not been known by you before see your doctor” I never know I have that and no symptom no treatment as well. So doctor what does the health screen result mean? Does that mean I confirmed had syphilis?Do I have it now ? Is that infecting to my husband now? Does my husband need do the test also? Do we both need treatment now? Appreciate your kindly advice on this. Looking forward to hearing from you urgently. Thanks.

    • Hi Vivian. Well first of all, I am very surprised that your results were just given to you without a Doctor giving you a full and proper explanation. Syphilis screening is very complicated and this is certainly not the platform to be giving you medical advice on this. It is not as straightforward as “the test is positive so you have Syphilis”. The test could be a false positive. Or maybe you do have latent Syphilis. As I said, it is too complicated to summarize here. You really should see a doctor well trained in interpreting Syphilis test results.

      • Doctor Tan, Thank you for your advising. I would like to bring my health screening report to doctors to get a detailed consultant. May I know does your clinics accept walk in consultant or shall I need make an appoinment?

  34. Hi Dr Tan,

    I had an exposure almost 2 years ago that I only recently found out about (penetrative vaginal sex, partner removed condom without my knowledge). I found out because I got tested positive for another STD and was not sexually active otherwise. The clinic I went to used the RPR to test for Syphilis but I read that the RPR could be non-reactive for late-latent syphilis, which is probably the case for a 2 year old infection. Can I trust this non-reactive RPR or what sort of testing is optimal for me? I’m really worried.

    • You are right. That is why we always use BOTH a Treponemal and Non-Treponemal test to screen for Syphilis. You should talk to your doctor about this.

  35. I had an RPR test at 7.5 weeks post exposure that came back negative, is this conclusive? I also had my hepatitis tests at 8 weeks post exposure and all came back negative, wondering if I should retake the tests as I am now 15 weeks post exposure. I got my HIV testing done at 13 weeks and it was negative, so I know I can put that to rest.

    • In my view your tests are not conclusive. Please verify this with the doctor who did the tests for you.

      • Thanks Dr Tan. Is that inconclusive for both the Syphilis and Hepatitis? I read that Hep A and C are conclusive at 6 weeks.

      • Michael

        Hello Sir,
        Im male received unprotected oral from a women, I took the STD test after 8 months, I’m worried about syphilis, I took RPR test and it came non reactive after 8 months. I read that RPR could be non reactive for Late & Latent, I’m not sure if my case falls under late or Latent. Can you please let me know if I can consider RPR negative after 8 months as conclusive and relax?

        • As stated in the article above, I recommend doing both the treponemal and non-treponemal tests for screening. Please speak to the doctor who did the test for you.

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