I have a question about syphilis screening and I'm really confused. unfortunately because of lack of sexual health access and knowledge I didn't know syphilis was even a thing to test for and all my tests till now were only for hiv, gonorrhea and chlamydia all of which negative. I'm a straight female in my thirties with relatively low risk exposure but like you never know who has what these days. I learnt about syphilis this year and ordered a test that was named RPR which came out negative but there are two other tests for syphilis so I'm confused. is RPR the correct test to use for screening for someone my age? I read online that it might be false negative, since this is the first time I've ever tested for syphilis and I'm already in my thirties would that test be positive if I got syphilis many years ago? I don't have any symptoms not even headaches so I'd think if I had something like syphilis for a really long time maybe I'd have some symptoms but I just want to know if I need to order any of the other tests to confirm I don't have this infection. I'm scared of blindness.

Syphilis testing is performed on blood specimens and is done in a two-step fashion. Testing is typically done using an initial, “screening” test using either the RPR test which you had or using a so-called “treponemal” test such as an EIA test. Screening with either test is fine and if the screening test is positive it is typically confirmed with the other type of test. This two-step testing rules out the possibility of falsely positive results.  Falsely positive tests occur about 1% of the time and are ruled out through the two-step testing process described above. Falsely negative tests, on the other hand, are very rare.  The problem of falsely negative tests is overstated on the internet.  Your RPR test was negative and should be believed. Even if you had acquired Syphilis years ago, if the disease was present and untreated your test would almost certainly be positive.

I hope the information I have provided above is helpful. If anything is unclear or there are further questions, please feel free to use your update to follow up questions for clarification. You can rest a sure that you do not have Syphilis. I do not see a need for further testing.  EWH