Screening check
Should I get screened for syphilis?
Syphilis can cause serious health problems if left untreated, and in pregnancy it can pass to the baby. The US Preventive Services Task Force recommends screening people at increased risk and every pregnant person. Check where you fall.
About you
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What you will see
Whether the USPSTF recommends syphilis screening for you.
Educational only, not medical advice. Talk to a clinician about testing.
Source
US Preventive Services Task Force: September 2022 recommendation for nonpregnant adolescents and adults, and May 2025 recommendation for pregnancy.
Validated in
Teens and adults without signs or symptoms of syphilis, including pregnant people.
Limits
It is not a test and does not cover people with symptoms. The USPSTF did not review screening done as part of HIV care or HIV PrEP; the CDC has advice for those groups.
What the USPSTF recommends
| Who | Recommendation | Grade |
|---|---|---|
| Teens and adults, not pregnant, ever sexually active and at increased risk | Screen for syphilis (USPSTF 2022) | A |
| All pregnant people | Screen as early in pregnancy as possible; if missed, at the first chance (USPSTF 2025) | A |
Who is at increased risk
Risk is higher in men who have sex with men, people with HIV or another sexually transmitted infection, people who use illicit drugs, and people with a history of incarceration, sex work or military service (USPSTF 2022). How common syphilis is in your community also counts, so clinicians are asked to weigh local rates and individual risk (USPSTF 2022).
Why it matters
Untreated syphilis moves through stages and can cause serious health problems. About a third of latent cases progress to tertiary syphilis, which can affect many organs. At any stage it can attack the nervous system or eyes, causing problems such as paralysis, dementia or blindness. It also raises the risk of getting or passing on HIV (USPSTF 2022). US rates of primary and secondary syphilis rose from a record low of 2.1 per 100,000 people in 2000 and 2001 to 11.9 per 100,000 in 2019 (USPSTF 2022).
In pregnancy, untreated syphilis can pass to the baby. Congenital syphilis is linked to premature birth, low birth weight, stillbirth, newborn death and lasting problems such as vision or hearing loss. In 2023 there were 3,882 cases of congenital syphilis in the US, including 279 stillbirths and infant deaths, the highest number in over 30 years (USPSTF 2025).
The test
Screening is a blood test for antibodies, done in two steps. The traditional order starts with a nontreponemal test (VDRL or RPR) and confirms a positive result with a treponemal test such as TP-PA. The reverse order starts with an automated treponemal test and confirms with a nontreponemal test (USPSTF 2022). In pregnancy, screening should include both kinds of test (USPSTF 2025).
How often
The best interval for people at increased risk is not well established. Men who have sex with men and people with HIV may benefit from testing at least once a year, or every 3 to 6 months if they remain at high risk (USPSTF 2022). In pregnancy, the CDC and other groups also advise testing again at 28 weeks and at delivery for people at high risk, and ACOG advises retesting everyone in the third trimester and at birth, as cited by the USPSTF (USPSTF 2025).
Treatment
Penicillin G given by injection is well established as treatment; the dose and length depend on the stage (USPSTF 2022). In pregnancy it is the only treatment with documented effect, and people with a penicillin allergy are desensitized and then treated with penicillin (USPSTF 2025).
Common questions
I was tested before this pregnancy. Do I need it again?
Yes. The CDC, ACOG and other groups recommend screening all pregnant women at the first prenatal visit, even if they were tested before, as cited by the USPSTF (USPSTF 2025).
Does this apply if I have symptoms?
No. The screening advice is for people without signs or symptoms (USPSTF 2022). See a clinician to get checked.
Also see the chlamydia and gonorrhea screening check, the HIV screening check, the genital herpes screening check, the hepatitis B screening check and all screening tests by age.
Sources
- US Preventive Services Task Force. Screening for Syphilis Infection in Nonpregnant Adolescents and Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA. 2022;328(12):1243. www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening
- US Preventive Services Task Force. Screening for Syphilis Infection During Pregnancy: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA. 2025;333(22):2006. www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-in-pregnancy-screening
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-10-30. Spotted an error? See About.