Online syphilis test referral · Australia-wide testing
FREEwith Medicare (bulk-billed)
A Specialist GP arranges your test over a quick phone call — they review your symptoms and risk, then send your pathology referral by SMS. No Medicare? Prefer no call? Order it online for $39 instead.
Syphilis is easily missed early, so testing after any risk is worthwhile.
Book a bulk-billed phone consult — or order a $39 referral
Get tested at any pathology lab Australia-wide — simply walk in
Results by SMS in 2-3 days — free telehealth if positive
Pathology tests covered by Medicare and most Private Health Insurers.
Syphilis Testing
Syphilis has a longer window period than most STIs. The blood test is reliable from about 6 weeks after exposure, and up to 12 weeks to be fully confident — testing earlier can miss a recent infection. If you have a sore (chancre), a swab of it can detect syphilis earlier, from when the sore first appears.
Not sure which option? A phone consult suits anyone with symptoms, a partner who has tested positive, or a known exposure. With no symptoms, the no-appointment referral is ideal for routine screening.
How the test works. The lab uses two tests together: a screening test that detects antibodies to the syphilis bacterium (telling you whether you have ever had syphilis), and a confirmation test that measures disease activity. This two-step approach is why a positive screen is always confirmed before it means anything definite, and why results are sometimes reported as a titre (a number) that helps track whether an infection is active or already treated.
Syphilis comes in stages. A painless sore at the site of infection, usually around 3 weeks after exposure; then a rash, fever, or swollen glands weeks to months later; then a latent stage with no symptoms that can last years. Because that first sore is easily missed, many people do not know they have it.
Why it matters. Rates in Australia have risen sharply over the past decade. Untreated syphilis can cause long-term damage to the heart and brain, and can be passed to a baby in pregnancy — which is why it is part of routine antenatal screening. It is treatable at every stage, and earlier treatment is simpler.
What a positive result means. A Specialist GP calls you to explain the result and the likely stage, and arranges treatment. Syphilis treatment is given as an in-person appointment rather than by telehealth alone.
Testing alongside other STIs. Syphilis is one of the five infections in the standard STI screen — chlamydia, gonorrhoea, syphilis, HIV, and hepatitis B — so you can test for all five from a single referral — worthwhile because syphilis often has no symptoms and shares risk factors with the others.
Cost and confidentiality. Pathology tests are covered by Medicare and most Private Health Insurers. Your referral and results are private, and labs do not disclose the reason for testing.
Following treatment. Syphilis is treated with injections. Afterwards the RPR titre is repeated over time to confirm the infection is responding — a falling number shows treatment is working. Re-infection is possible, so ongoing screening is sensible if you remain at risk. In pregnancy, syphilis is checked early and again later, because early treatment prevents it passing to the baby.
Partner notification. Recent partners should be told so they can test and treat — this can be done anonymously through the Let Them Know service if you prefer.
Frequently asked questions
At least 6 weeks. Syphilis antibodies take 3 to 6 weeks to develop after the initial infection, so a test before then can miss the infection even if you have caught it. If you have symptoms suggesting primary syphilis (a painless ulcer at the site of contact, usually 3 weeks after exposure), testing earlier is reasonable because the test may already be positive. But for someone without symptoms who wants to rule out a recent exposure, 6 weeks is the standard wait. A negative test before 6 weeks should be repeated.
Yes. A painless ulcer that heals on its own in 3 to 6 weeks is the classic presentation of primary syphilis. The ulcer healing does not mean the infection has resolved — the bacterium is now in the bloodstream and will progress to secondary syphilis (rash, fever, swollen glands) and then to latent syphilis if not treated. The blood test will detect the infection regardless of whether the original ulcer is still visible.
Australian syphilis rates have risen substantially since around 2010, first in men who have sex with men, then in heterosexual networks (particularly in regional and Indigenous communities), and more recently in women of reproductive age. The rise in women of reproductive age is the most concerning pattern because untreated syphilis in pregnancy can cause stillbirth and serious harm to the baby. Public health responses include expanded antenatal screening and more frequent screening for people in higher-prevalence groups.
Possibly. A rash that involves the palms and soles is a classic feature of secondary syphilis, which develops 6 weeks to several months after the initial infection. The rash is often not itchy and may be subtle. Other secondary syphilis features include fever, sore throat, swollen glands, patchy hair loss, and mouth ulcers. The rash itself is not specific to syphilis — many other conditions can cause similar appearances — but it is worth testing if there is any possibility of unprotected sexual exposure in the previous several months.
Both are used together to make a syphilis diagnosis. The treponemal test (such as a TPHA or EIA) detects antibodies to the syphilis bacterium itself and tells you whether you have ever had syphilis. It usually stays positive for life, even after treatment. The RPR (or VDRL) measures non-specific antibodies that correlate with disease activity — the level rises during active infection and falls after successful treatment. Both tests together let the Specialist GP distinguish between current infection, past treated infection, and a rare false-positive screen.
Australian guidelines recommend 3-monthly screening for syphilis (alongside HIV, chlamydia, and gonorrhoea) for people taking HIV PrEP, and for sexually active gay, bisexual, and other men who have sex with men more broadly. For people with multiple partners or with a history of recent syphilis, 3-monthly is the standard. For people in a stable relationship, less frequent screening may be appropriate. See when to test after exposure for the full guide.
Yes, particularly if you are pregnant or planning pregnancy, or if you have new or multiple sexual partners. Syphilis rates in heterosexual women of reproductive age have risen substantially over the past five years, and untreated syphilis in pregnancy is one of the most damaging STI outcomes (stillbirth, premature birth, congenital syphilis). A syphilis test is included in routine antenatal screening and in the standard comprehensive STI panel.
Book a phone consult. The Specialist GP discusses the timing of your last sexual contact, whether to test now or wait until 6 weeks have passed, and whether to treat based on the partner diagnosis even before your own test is back. For someone with recent contact with a syphilis-positive partner, treatment based on the contact alone is often offered — this is one of the few STIs where treating before the test result is back is part of standard guidelines, because syphilis can be infectious without symptoms.
Your result is confidential. Your regular GP is not automatically notified unless you ask to be copied in, and pathology labs do not disclose the reason for testing. If you would prefer the result kept separate from your other medical records, mention it at the consult and it can be arranged. Syphilis is a notifiable infection, so the lab notifies the state public health authority for surveillance and partner-notification support, but that notification does not usually include your full identifying details.
The treponemal screening test usually stays positive for life after a syphilis infection, even after successful treatment. The RPR (the activity test) should have dropped substantially after treatment and may be very low or negative now. When testing someone with a history of treated syphilis, the Specialist GP compares the current RPR to the post-treatment level. A four-fold rise in the RPR titre suggests re-infection or reactivation. Bring any records of your previous treatment to the consult if you have them — they make interpretation much simpler.
