Syphilis: What to Do After a Positive Test Result

Q: Syphilis: What to Do After a Positive Test Result

Hello： The syphilis test (4X) will prompt your military unit to notify you for a follow-up appointment. <br>HIV testing is conducted during the military examination. <br>If you have engaged in unprotected sexual intercourse, I personally recommend getting tested every six months

About syphilis?

Hello, doctor.
A few months ago, I had a physical examination for military service, and the results showed a positive reaction for syphilis (4X), but there was no reaction for HIV.
In mid-February of last year, I had intimate contact with a stranger, during which she used a condom for oral sex, and there was no vaginal penetration.
I am very concerned and would like to ask if I should go to the hospital now instead of waiting for the military's follow-up appointment, which is more than a month away.
Should I get tested for syphilis with the TPHA test? Should I also get tested for HIV? What is the likelihood of contracting an infection in this situation? Since last year, my health has been very good, and I have not experienced any symptoms such as rashes or genital ulcers.
The only unusual incident was a sudden high fever last October, for which I went to the hospital for blood tests, but no cause was found.
I ended up receiving IV fluids in the emergency room for a day, and the fever subsided naturally.
Thank you for your help!

Xiao Liao, 20~29 year old female. Ask Date: 2017/01/21

Dr. Du Shixi reply Urology

Hello: The syphilis test (4X) will prompt your military unit to notify you for a follow-up appointment.
HIV testing is conducted during the military examination.
If you have engaged in unprotected sexual intercourse, I personally recommend getting tested every six months (not exceeding six months).
If you notice any abnormalities, you should seek medical attention.
If possible, it is better to have a consistent physician to avoid repeating your medical history each time, and reports from the same hospital's laboratory tend to be more objective.
(Many patients are also unclear about where they contracted syphilis or HIV; the key factor is the sexual partner.
If your partner has these infections, you are at risk.
Additionally, practicing safe sex, using condoms, and regular check-ups are essential.
Thank you for your inquiry.
In Taiwan, there are several thousand reported cases of HIV, so please be cautious.)

Reply Date: 2017/01/21

More Info

If you have received a positive test result for syphilis, it is crucial to take immediate action. Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum, and it can have serious health implications if left untreated. Here’s what you should do following a positive test result:
1. Seek Medical Attention Promptly: It is advisable to visit a healthcare provider as soon as possible rather than waiting for your scheduled military appointment. Early intervention is key in managing syphilis effectively. Your healthcare provider will likely perform additional tests to confirm the diagnosis and determine the stage of the infection.

2. Testing for Syphilis: You mentioned the TPHA (Treponema pallidum hemagglutination assay) test. This test is commonly used to confirm syphilis. However, it is also important to conduct other tests, such as the RPR (Rapid Plasma Reagin) or VDRL (Venereal Disease Research Laboratory) tests, which can help assess the activity of the infection. Your doctor may also recommend a complete blood count and liver function tests to evaluate your overall health.

3. HIV Testing: Given that syphilis is an STI, it is highly recommended to get tested for HIV as well. The presence of syphilis can increase the risk of contracting HIV, and vice versa. Knowing your HIV status is essential for your health and for the health of your partners.

4. Understanding Risk Factors: You mentioned that your sexual encounter involved protected oral sex. While using a condom significantly reduces the risk of transmitting STIs, it is not 100% effective, especially for oral sex. The risk of syphilis transmission through oral sex is lower than through vaginal or anal sex, but it is still possible. The fact that you have not experienced any symptoms such as rashes or sores is a positive sign, but it does not rule out the possibility of infection.

5. Treatment Options: If syphilis is confirmed, the standard treatment is a course of antibiotics, typically penicillin. The treatment is effective, especially in the early stages of the infection. Your healthcare provider will guide you on the appropriate dosage and duration of treatment based on the stage of syphilis.

6. Follow-Up Care: After treatment, follow-up testing is essential to ensure that the infection has been cleared. This usually involves repeat blood tests at intervals specified by your healthcare provider.

7. Informing Partners: It is important to inform any sexual partners about your diagnosis so they can also get tested and treated if necessary. This helps prevent the spread of the infection.

8. Mental Health Considerations: Receiving a positive test result can be distressing. It is important to seek support from healthcare professionals, counselors, or support groups to help you cope with any anxiety or fear related to your diagnosis.

In summary, do not delay seeking medical care after a positive syphilis test. Early diagnosis and treatment are crucial for a full recovery and to prevent complications. Additionally, consider getting tested for HIV and informing your partners to ensure comprehensive care and prevention. Your health and well-being are paramount, and taking these steps will help you manage your situation effectively.

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