Understand your
First To Know®
syphilis test results and see a doctor online

Confidential testing and treatment for syphilis from the comfort of home.

1

If you have symptoms of syphilis (even if your First To Know® syphilis test is negative).

2

If you have been exposed to someone who has syphilis even if your First To Know® Test is negative.

3

If you have a positive syphilis test and you have not been treated for syphilis.

The First To Know® test checks for a type of antibody called ‘treponemal antibodies’. A positive First To Know® syphilis test result means that you have antibodies that may indicate a current syphilis infection OR a past syphilis infection. To start treatment for syphilis, we also need to check ‘non-treponemal’ antibody titers so your healthcare provider can track your response to treatment.

We’ll order the testing you need to get a full diagnosis. Get a telehealth visit to get treatment and ongoing care.
Testing for both Non-treponemal antibody titers and Treponemal antibody levels are needed to diagnose and treat syphilis.
Full STI Screening is also recommended at the same time to detect any associated STIs.

In Lab Test

Positive when you have syphilis and with

some health conditions.
HIV/AIDs
Viral hepatitis infection
Malaria
Walking pneumonia (mycoplasma)
Infectious Mono (EBV)
Systemic Lupus (SLE)
Rheumatoid arthritis
Antiphospholipid syndrome
Liver disease (cirrhosis)
Kidney disease (especially dialysis)
Pregnancy
Recent immunization (influenza, MMR, Smallpox, Hepatitis B)
Certain medications (warfarin, heparin, aspirin, tetracyclines, rarely penicillin, methotrexate)
IV drug use (heroin and cocaine)

For this reason, it is important that we check your treponemal antibodies at the same time. If BOTH tests are negative and you are still concerned that you may have syphilis, repeat both tests in one month.

We’ll also check your antibody titers (the number of antibodies) if this test is positive. The titer numbers are tracked to make sure they go down after treatment. This number serves as your baseline before treatment and is retested and tracked over time.

In Lab Test

Positive when you have an active infection AND if you’ve had an infection in the past. These antibodies are usually positive for life. The laboratory will run this test only if your non-treponemal antibodies are positive. If both tests are negative and you have symptoms or have had sex with someone who has been diagnosed with syphilis in the last 90 days, you should get treatment now.

This test screens for ten additional STIs that are associated with syphilis at the same time.

Designed to be completed along with the in laboratory syphilis confirmation test. We’ll check for the following:

Chlamydia
Gonorrhea
Trichomonas
Mycoplasma
Hep B
Hep C
HIV 1
HIV 2
HSV 1
HSV 2

You can order lab testing first and then schedule a telehealth visit for results and management, or you can see a provider on AZOVA first to determine the right tests for you.

  • Benzathine Penicillin G: This is the treatment of choice for the earlier stages of syphilis. The number of doses that you need depends on how long you have been infected and what your symptoms are.
  • Doxycycline: This antibiotic can be used only if you are not allergic to penicillin. Treatment outcomes are better when treated with penicillin.
  • Tetracycline: This antibiotic can be used if you are allergic to penicillin.
  • Ceftriaxone: This antibiotic is used by patients who are allergic to penicillin and cannot take doxycycline or tetracycline and who are not allergic to cephalosporins.

1

You will monitor non-treponemal antibody titers over the next 12 months to assure that the infection is cleared.

2

If you are sexually active and have unprotected sex, your provider will recommend regular STI screening in addition to syphilis monitoring.

3

You will have follow up visits with your provider as directed to monitor your health and manage your response to treatment.

Stay informed, stay healthy, and take charge of your sexual health!