At-home Syphilis Test
Written by Ada’s Medical Knowledge Team
A syphilis test is an important tool to diagnose syphilis, as this STD often presents itself with mild or general symptoms. Syphilis symptoms can disappear without treatment, but the bacteria that causes the condition remains present in the blood. This causes further progression of the condition, even without any symptoms present. After decades, you may experience life-threatening complications when the syphilis infection becomes visible again. To prevent this from happening, it’s important to regularly take a syphilis test if you’re sexually active. That way you can protect your own health and the health of your sexual partners.
What is a syphilis test?
A syphilis test is used to diagnose syphilis. Syphilis is an STD that occurs frequently, and that can have a big impact on your health. The symptoms of syphilis may easily be mistaken with other conditions, which makes it hard to diagnose the STD just by performing a physical examination and listening to the medical history. A syphilis test can confirm whether or not the bacteria Treponema pallidum, which causes syphilis, is present. 1
Diagnosing syphilis is very important as treponema pallidum can be transmitted to others by coming into contact with the sores caused by syphilis. The condition can also cause serious consequences for your own health. Syphilis usually progresses in phases, being: 1 2
- Primary syphilis: usually marked by a painless ulcer, otherwise known as a chancre or a number of sores on the genitalia which are painless and go away on their own.
- Secondary syphilis, which causes skin rashes and general symptoms such as fever, a sore throat, headaches and weight loss. Secondary syphilis can also cause swollen lymph nodes, mouth sores, fatigue, and loss of appetite. These symptoms will go away on their own again, but without treatment the condition will keep evolving and may affect other organs.
- Latent stage: this is the stage where there are no symptoms of syphilis, although the bacteria stays present in the body.
- Tertiary syphilis: this is the last stage of syphilis, which can occur decades after the first infection. Tertiary syphilis can affect a number of vital systems in the body, especially the nervous system, the eyes and the auditory system.
In order to stop the condition from evolving into the next phase and avoiding these consequences that could be fatal, it’s important to get tested regularly. Testing is especially necessary if you are experiencing symptoms that may indicate a syphilis infection. If you’re sexually active, it’s advised to get screened regularly for syphilis, as the beginning stages may not always be noticed and the latent stage doesn’t go with any symptoms. 1
A syphilis test can be used for various reasons: 3 4
- Screening of people without symptoms: This is mostly done for people who run a high risk of contracting syphilis.
- Diagnosing syphilis in people that experience symptoms.
- Monitoring to see if syphilis treatment has been effective
- Screening of blood donors
When should I get tested for syphilis?
You should get tested for syphilis if:
- You’re experiencing symptoms of syphilis,
- Your sexual partner has symptoms of syphilis or has told you that they have syphilis.
- You’ve had unprotected sex or shared sex toys with a new partner.
- You’ve shared needles or syringes with someone who might have syphilis.
- You have multiple or anonymous sexual partners
If you’re pregnant, you should always get tested for syphilis as the bacteria can also infect your unborn child. This causes a condition called congenital syphilis, which means a case of syphilis that is present from before the baby is born. Not all babies with congenital syphilis show symptoms of infection. Without treatment, serious health problems may occur days or years later. Untreated syphilis may also have serious complications for your pregnancy, including miscarriage or stillbirth. 5
How to test for syphilis?
You can get tested for syphilis in multiple ways: 3 6 7
- If you go to your practitioners office or a sexual health clinic, the practitioner will draw some blood from a vein. This sample will be sent to a laboratory, where two tests will be done. First, a nontreponemal test will be done. This test looks for antibodies produced by the body that aren’t specific for Treponema pallidum. This test is mostly used for screening. In case this test is positive, meaning that these antibodies are present in the blood, a second test will be done. This test is a treponemal test, which specifically looks for antibodies that the body produces as a reaction to Treponema pallidum. The treponemal test is used as a confirmation that syphilis is present.
- You can also take the treponemal test at home. This is done by pricking your finger to collect a sample of your blood. This sample then has to be sent to a laboratory for analysis. However, it should be noted that people who’ve had a syphilis infection in the past will still have antibodies in their blood and will therefore also test positive, even if the condition has been treated successfully.
- You can also get a syphilis swab test done if you have sores which may point to a syphilis infection. This means that a sample of fluid from the sores will be collected using a swab, which looks like a cotton bud. This sample will then be sent to a laboratory for analysis.
- You can also take a panel test at home to test for the 5 most frequent STDs, being chlamydia, HIV, syphilis, trichomoniasis and gonorrhea. This test works with a blood prick test and a urine sample that you can collect yourself. After taking the samples, you send them to a laboratory, where they will analyze the samples and inform you on your results.
It is advised that if you are diagnosed with syphilis, you should also be screened for chlamydia, gonorrhea, and blood-borne viruses such as hepatitis B and C. Syphilis also plays a large role in facilitating HIV transmission, therefore all who are tested positive for syphilis should also be tested for HIV. 4
How to read syphilis test results?
The interpretation of syphilis test results is fairly easy. If your syphilis test results are positive, that means that you have a syphilis infection. If the results come back negative, that means that you aren’t infected with syphilis. 6
There are however a few cases where the syphilis test result interpretation isn’t that simple. This can be the case with nontreponemal tests when someone has an acute or chronic disease unrelated to syphilis that also causes a reaction by the body which could be mistaken for a reaction to syphilis. Examples of these conditions are autoimmune disorders, tuberculosis and endocarditis. For this reason, the laboratory will also run a treponemal test, which confirms or rules out a syphilis infection.
A false positive syphilis test can also happen when you take an at-home treponemal test and you’ve had syphilis in the past. As the antibodies that the body creates against syphilis remain in the blood, it will cause a positive reaction in the treponemal test, even if you’re not infected at the moment.
What to do if I test positive for syphilis?
If you’ve tested positive for syphilis, you should:
- Talk to your practitioner to start treatment immediately. Treatment may be different according to the stage of syphilis that you’re in or your personal situation.
- Notify your sexual partners so that they can get tested too.
- Monitor the outcome of your treatment. Your practitioner will test you again after treatment, to make sure that treatment has been successful.
Q: Where can I get tested for syphilis?
A: You can get tested for syphilis at your medical practitioners office or a sexual health clinic. You can also take a syphilis test at home.
Q: How soon after a risk contact will a syphilis test show positive?
A: It can take between 10 to 90 days after the initial infection for syphilis to turn up in blood tests.
CDC (2022). Sexually Transmitted Diseases (STDs) Detailed Fact Sheet. Accessed on July 17, 2022.
MSD manuals (2021). Syphilis. Accessed on September 9, 2022.
CDC (2022). Sexually Transmitted Infections Treatment Guidelines 2021. Accessed on July 18, 2022.
BMJ (2022). Syphilis infection - symptoms, diagnosis, screening. Accessed on September 9, 2022.
CDC (2022). Congenital Syphilis Fact Sheet. Accessed on July 17, 2022.
NHS (2022). Syphilis. Accessed on July 18, 2022.
CDC (2019). Immigrant, Refugee and Migrant Health. Accessed on July 18, 2022.