Sexually Transmitted Diseases/Syphillis Testing


Hello Mr. Behar,
   My name is Alex. I am 23 years of age and currently residing in Canada. I had a question about getting tested for possible syphillis infection. I performed an oral on this guy who I met without a condom. I did not engage in any other further activity. Within the first 3 months I started to feel un well and I had attributed it to the flu/ cold virus that was going around at the time. However, I began to think that what I was feeling had something to do with what I had done a few months before. I went to my local sexual health clinic and explained to them what happened. I did a rapid test for HIV and it was negative. They had told me the risk was low bur the risk for chlamydia and gonorrhea along with syphillis was moderate. I did a swab test and urine test for them (except for syphillis). They turned out negative as well. I am wondering about syphillis tests and symptoms. Do symptoms happen in everyone. I have watched myself over the past few months and didn't see any symptoms. I'm a concerned that I may not have had symptoms but may be infected. When I performed the oral, I did not exchange or receive any fluid as well, I did not not see any visible chancres or sores. At this point a blood test would be the logical step to see if I was exposed. As such, is there a window period in which I have to wait to see if I was infected? Additionally, if the expose happened say more than a year ago but less than 2, will the infection still be in my blood or be detectable? Thank you for your time in answering this question. All the best ~Alex

Hello Alex,
Thanks for your thoughtful questions.  Although syphilis is thought of as the "great imitator" due to it's signs and symptoms mimicking so many other more benign conditions, a blood test can accurately detect presence of antibody to syphilis anywhere from 3 weeks to 3 months after infection.  The antibody test remains positive ("reactive") until it is properly treated with injectible penicillin (unless a person is penicillin allergic). If you were infected a year or ten years ago, and never received effective treatment, than this blood test will most certainly be reactive.  In any event penicillin will be effective, and a blood test is warranted.  

Hope this addresses your concerns. Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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