When and where can you get tested for syphilis?

It is a good idea to have a syphilis test if you notice typical symptoms – like a chancre sore in the primary stage of the disease. This painless sore mainly develops in the genital area, mouth, or around the anus (bottom).

It is not at all uncommon to have syphilis without any symptoms. So it's sometimes still important to get tested even if you don’t have symptoms – if

• you find out that a sexual partner has syphilis, or
• you have an increased risk of sexually transmitted diseases (for instance, because you have sex with a lot of different people). Experts then recommend regular testing – for example, every three months.

Pregnant women are also advised to have a syphilis test as early as possible in pregnancy. Syphilis could harm the unborn baby, so it can be a good idea to check. The tests are part of standard prenatal care in Germany.

The test involves taking a blood sample. The blood is examined in a laboratory to see if it contains any antibodies to the syphilis-causing bacteria. If antibodies are found (a "positive" result), these findings have to be confirmed using a different type of test. If they are confirmed, the same blood sample is tested a third time to see if the infection needs to be treated or has already cleared up on its own.

So the syphilis test does not detect the syphilis bacteria themselves, but shows whether and how the body has reacted to the bacteria. The problem here is that it usually takes some time for the body to make antibodies after infection, so the test will come back negative if it's done too soon after infection. That means that if you had sex with a (potentially) infected person a few days earlier, it's a good idea to wait a while before having the test, or have a second one done at a later time. More specifically, it's best to wait at least three weeks before doing a test.

If you already have symptoms, syphilis can be diagnosed using other tests – such as a swab of the fluid in a chancre sore, which contains a lot of syphilis bacteria. The bacteria can be detected using a PCR test, for example.

Please note that some of the following information describes the situation in Germany specifically. You may find that things are different in other countries.

Dermatology, urology and gynecology practices offer syphilis tests, and some family doctors do them too. Tests for other STIs are often offered at the same time – particularly HIV tests, because people who have syphilis are also more likely to have HIV.

But it might not always be easy to talk openly with your doctor about sex and any STIs you might have caught.

In Germany, every syphilis infection is reported to the Robert Koch Institute, but the name of the infected person is not passed on. So it is anonymous.

Tests for syphilis and other STIs are also offered by local health departments, sexual health clinics and "checkpoints" of the German AIDS Service organization (Deutsche Aidshilfe). You can take the tests there anonymously and also get advice on things like what to do if your test result is positive. You usually have to pay for tests there yourself, but there are exceptions. A syphilis test at "checkpoints" usually costs between 10 and 25 euros.

There are rapid tests that, depending on the brand, provide results after just 15 minutes. They are sometimes offered by "checkpoints" and other centers. But experts recommend the laboratory test mentioned above because that is more reliable.

It is also possible to have everything you need for the laboratory test (including instructions) sent to your home. Responsible suppliers will advise you beforehand – typically by phone – and explain how the test works. You take the blood sample yourself (usually by pricking your fingertip) and then send it in to be tested in a laboratory. If the result is negative, you will usually be sent a text message telling you that. If it’s positive, reputable suppliers will contact you again to provide advice and tell you how and where you can get treatment. These types of tests cost between 50 and 60 euros. You have to pay for them yourself.