Syphilis can be quiet at first and dangerous later. Testing is the only way to know your status, avoid complications, and stop passing it on. This guide explains the common tests, when to test, how to read results, and practical next steps you can take today.
Most clinics use two types of blood tests. Nontreponemal tests — RPR and VDRL — look for general antibodies your body makes after infection. They’re inexpensive and useful for tracking treatment because the numbers (titers) fall if treatment works. Treponemal tests — TPPA, FTA-ABS, or modern EIAs — detect antibodies that specifically target the syphilis bacteria. Those often stay positive for life after an infection, even after successful treatment.
If you had unprotected sex, a new partner, or found a painless sore, get tested as soon as possible. For very recent exposure, antibodies might not show up right away. Many people will test positive by 3–6 weeks after exposure, but clinicians often repeat testing at three months to be safe. Pregnant people should be tested at their first prenatal visit and again in the third trimester if they remain at risk.
Tests use a blood draw. Rapid point-of-care tests are available in some clinics and give results in 20–30 minutes, but lab testing is more thorough. If cost is a barrier, look for public health clinics — many offer low-cost or free testing and anonymous services in some areas.
A positive treponemal test plus a positive nontreponemal test usually means active infection. If only the treponemal test is positive, that can mean past treated infection, very early infection, or a false positive; your provider will consider your history and may repeat tests. Nontreponemal titers (for example 1:32 or 1:8) help monitor whether treatment worked — falling titers show response, rising titers can mean reinfection.
False positives happen. Pregnancy, some autoimmune diseases, and certain infections can trigger nontreponemal reactivity. That’s why confirmatory treponemal testing matters. If you test positive, clinicians usually recommend treatment right away and testing for other STIs, including HIV. For pregnant people, prompt treatment prevents serious harm to the baby.
After treatment, follow-up tests at 6 and 12 months (or as your provider advises) check that titers fall appropriately. Informing recent partners is a key step — public health services can help with notification in many places. If you don’t know where to go for testing, call your local health department, search for sexual health clinics in your area, or ask your primary care provider. Knowing your status protects you and others, and testing is quick and widely available.
