Screening · Syphilis
Syphilis Screening
Syphilis is a bacterial infection that has been rising in the United States. It progresses in stages and can cause serious problems if left untreated, but it’s curable with antibiotics.
A simple blood test screens for it. Screening is especially important in pregnancy, to protect the baby.
The Basics
What is syphilis?
Syphilis is caused by a bacterium and spreads through sexual contact. It moves through stages: a painless sore (the primary stage), later a body rash (secondary), a hidden latent phase with no symptoms, and, if never treated, a tertiary stage that can damage the heart, brain, and other organs. Passed during pregnancy, it can seriously harm a baby (congenital syphilis).
Why the renewed attention?
Syphilis rates, including congenital syphilis, have risen sharply, so screening has become more important across more groups.
Who & When
The U.S. Preventive Services Task Force recommends:
- Screening people at increased risk who have no symptoms (Grade A), particularly men who have sex with men and people living with HIV.
- Everyone who is pregnant — screen early, and again later in pregnancy if at higher risk.
- With rising rates, screening is offered more broadly, especially alongside other STI testing.
The bottom line: screen if you’re at increased risk, and always in pregnancy.
The Test
Screening is a blood test, and confirmation uses a two-step approach: a nontreponemal test (such as RPR) and a treponemal test. Together they confirm infection and help judge whether it’s active. The nontreponemal titer is also used to track your response to treatment. See our syphilis blood test page.
Your Results
- Nonreactive — no evidence of infection.
- Reactive — confirmed with the second test and staged, then treated; the titer is rechecked over time to confirm the treatment worked.
Treatment
Syphilis is curable. The treatment is penicillin (usually an injection), with the number of doses depending on the stage. Partners should be tested and treated, and follow-up blood tests confirm the infection is cleared.
Higher Risk
Increased risk includes men who have sex with men, people living with HIV, those with multiple partners or a previous STI, people who exchange sex, and anyone who is pregnant. Testing alongside other STIs is a good routine when risk is present.
Signs to Watch
Symptoms can be easy to miss and come and go:
- A firm, painless sore, often on the genitals, mouth, or rectum
- A rash, classically on the palms and soles, weeks later
- Swollen glands, fever, or feeling generally unwell
The latent stage has no symptoms at all, which is why testing rather than waiting for signs is the way to catch it.
Useful Links
Talk it through with Dr. Mui
A quick blood test is all it takes. Book a visit and we’ll include it with your screening.
Prefer to ask first? Text Dr. Mui at 617-675-4085.
This page is for general education and isn’t a substitute for professional medical advice, diagnosis, or treatment. Screening guidelines change over time and the right plan depends on your personal risk. Always talk with a qualified health provider about your specific situation.