Hi mr. Hook and mr. Handsfield. I am a 25 years old heterosexual male. I got tested for syphilis along with HEP B&C, and HIV around 25 months after my last sexual encounter, it could be considered as a medium risk event. I read about the accuracy of syphilis testing in different stages. My syphilis test came back as "VDRL - RPR: Negative Titer" I don't live in the US, so I am not sure which test was done, but I think that's irrelevant. I've came across some replies from mr. Handsfield stating that the accuracy of RPR drops as the latency progresses. On the other hand, mr. Hook sometimes states the RPR stays positive regardless of the stage of the disease. I might be misreading your statements. If so, I wholeheartly apologize. I don't question your knowledge or your experience in the field. I am just very confused. As to my actual question, considering the fact that my last exposure was around 25 months (2 years) ago, can I trust my test result? I can't recall having any symptoms, but I wasn't worried about syphilis back then so I might've missed them. Regardless, I think testing is the only way to know. I just want to be 100% certain about the accuracy of it before moving forward.  Should I test for something else? Is VDRL or RPR enough in my case?

Welcome to our Forum and thanks for your confidence in our service.  I'll be glad to comment.---

Thank you sir. So what you are saying is  that my result is almost 100% correct not 80-85% or something lower. I couldn’t find a lab that does TPHA alone where I live. So I have to go to a private hospital if such a test is necessary, but if you’re confident that the result is true, I won’t spend my money on it. I read that syphilis infection from oral is unlikely, and that also gives me reassurance. My “exposure” was my ex girlfriend. She said that she always used protection during her relationships, but never got tested for anything. We were together for around 3 months. I used protection during penetration, but not for oral. One time I got exposed to her period blood orally as well although it was accidental. But I think period blood doesn’t increase much risk. I will believe your statement and believe my result. No more testing is necessary and I can move on.

I am confident that your result is true.  I am confident you do not need testing.  If you must prove this to yourself however, the tests which would absolutely PROVE that you have never had syphilis include the TPHA, the TPPA or the FTA - any of these tests will prove that you have never had syphilis when they are negative as I am confident they will be.  ---

Thank you doctor. I am confident in your experience, and suggestions. If you are confident, I don’t have any reason worry and question this any further. I appreciate your time and responses. 

I’m glad that you found my comments helpful. That’s what we’re here for. ---