Best At-Home Syphilis Test Kits for Convenient and Private Screening

The prevalence of syphilis has reached unprecedented heights in the US, marking a concerning trend in sexual health. In 2022, there were 207,255 reported syphilis cases, the highest since 1950, with a 17.3% increase from the previous year.

Among these cases, 59,016 were primary and secondary (P&S) syphilis cases, which are the most contagious stages of the disease. Since its record low in 2000 and 2001, the rate of P&S syphilis has been rising almost yearly, with a 9.3% increase from 2021 to 2022.

This increase in infections poses health risks and societal challenges. Moreover, the stigma surrounding the disease can cause shame and reluctance to seek testing or treatment, contributing to its spread.

Recognizing the need for accessible testing, new at-home test kits have been developed, offering quick and reliable results without concerns about time, location, or stigma. This article will review the leading at-home syphilis test kits, discussing their features, reliability, and cost. By sharing these convenient testing options, we hope to encourage people to prioritize their sexual health.

Understanding Syphilis

Syphilis, an infection caused by the bacterium Treponema pallidum, is a sexually transmitted disease (STD) that can be contracted through sexual contact (vaginal, anal, or oral sex) or passed from mother to unborn child during pregnancy. It manifests in several stages, each with its distinct symptoms:

• Primary syphilis: Marked by the development of a painless sore (chancre) at the infection site, typically the genitals, anus, or mouth.
• Secondary syphilis: Symptoms may include a skin rash, swollen lymph nodes, fever, sore throat, muscle aches, and fatigue. These symptoms may come and go over time.
• Latent syphilis: The infection remains dormant in the body without causing symptoms, persisting for years.
• Tertiary syphilis: In some instances, if left untreated, syphilis can progress to severe complications such as heart damage, brain damage, nerve damage, vision problems, and damage to other organs.

Diagnosis of syphilis typically involves blood tests and examination of samples from any sores present. Practicing safe sex and undergoing regular STI screenings are essential preventive measures.

Understanding Syphilis Testing

Syphilis can present with a wide range of symptoms and clinical manifestations. These can vary depending on the stage of the infection and the individual's immune response.

Several tests are involved in the diagnostic process, each serving a specific purpose and providing complementary information. Below, we'll discuss these tests and their sequence.

Diagnostic Tests for Syphilis

Due to the variability in symptoms and the overlap with other diseases, the diagnosis of syphilis must be confirmed through appropriate laboratory tests.

Here are two diagnostic tests conducted for syphilis:

Direct Detection Methods

Several tests can directly detect the bacterium Treponema pallidum. These include:

1. Dark-field Microscopy: This method involves examining fluid from lesions under a microscope, which enables visualization against a dark background. Treponema pallidum is identified by its characteristic spiral shape and movement. It's most effective when lesions are moist and examined promptly after collection.

This technique is particularly useful in early syphilis when antibodies aren't yet detectable, common in patients with immunodeficiency or in early-stage cases. However, despite being definitive, a negative result of this test doesn't necessarily rule out syphilis.

2. Direct Fluorescent Antibody Test for Treponema pallidum (DFA-TP): This method is simpler to perform than dark-field microscopy. It detects antigens, so it doesn't rely on the presence of moving treponemes.

It uses a labeled antibody specific to pathogenic treponemes, making it suitable for examining oral and rectal lesions. However, it doesn't distinguish between T. pallidum and other pathogenic treponemes that cause diseases like yaws, endemic syphilis, and pinta.

3. Nucleic Acid Amplification Methods: This involves using techniques like Polymerase Chain Reaction (PCR) to amplify and detect the genetic material of Treponema pallidum. Though not standardized, it’s highly sensitive and can accurately detect one to 10 organisms per sample.

These methods are practical in diagnosing congenital syphilis, neurosyphilis, and early primary syphilis. PCR could also be useful for monitoring treatment and distinguishing new infections from old ones. While commercial PCR-based test kits aren't currently available, some labs may offer this service.

Serologic Tests

Serologic tests, also known as serological tests, are diagnostic tests that detect antibodies, antigens, or other substances in the blood serum. There are two primary classifications of serological tests in syphilis testing:

1. Non-Treponemal Serological Tests

Non-treponemal tests check for antibodies, called immunoglobulin G (IgG) and immunoglobulin M (IgM), released by damaged cells during syphilis infection. There are three types of nontreponemal tests available in the US:

• Venereal Disease Research Laboratory (VDRL)
• Rapid Plasma Reagin (RPR)
• Toluidine Red Unheated Serum Test (TRUST)

These tests measure how active an infection is and are reported as a "titer," showing how often your blood was diluted before the antibodies were still detected. It usually takes about three weeks for the antibodies to show up, but sometimes it can take up to 6 weeks. However, these tests can sometimes show a false positive result.

2. Treponemal Serological Tests

Treponemal tests, also called confirmatory tests, are used to confirm if someone has syphilis. They detect antibodies specifically produced in response to Treponema pallidum (treponemal antibodies), which show up earlier after a person gets infected compared to other types of antibodies.

The available treponemal tests in the US include:

• Fluorescent Treponemal Antibody Absorption (FTA-ABS)
• Microhemagglutination - Treponema pallidum (MHA-TP)
• Treponema Pallidum - Particle Agglutination (TP-PA)
• Enzyme Immunoassay (EIA)
• Chemiluminescent Immunoassay (CIA)

Treponemal tests usually show either reactive or nonreactive results. A reactive result means there's been an infection, but it doesn't confirm if it's recent, old, or treated.

Syphilis Testing Algorithms

There are two approaches considered in syphilis testing. These are:

Traditional Testing Algorithm

In the past, the standard procedure for testing syphilis typically starts with a non-treponemal test. If this test shows a positive reaction, indicating the presence of certain antibodies in the blood, a treponemal test is then conducted to confirm the diagnosis of syphilis.

Here’s a sample interpretation of the traditional testing for syphilis:

This approach has been the standard practice for a long time and is widely recognized for interpreting test results.

Reverse Testing Algorithm

The reverse testing for syphilis starts with a treponemal test. If the test shows a positive result, indicating the presence of specific antibodies, a non-treponemal test is then conducted.

If the non-treponemal test comes back negative, suggesting no antibodies are present, a second treponemal test is performed to check if the initial positive result was accurate. This second treponemal test must be different from the first one.

Here's an example interpretation of the reverse syphilis testing:

This reverse approach has been used since 2009 and is particularly beneficial for high-volume laboratories as it reduces manual labor associated with non-treponemal tests. Additionally, this algorithm can detect past infections that may have been missed by the traditional testing method.

The Centers for Disease Control and Prevention (CDC) suggests that individuals who test positive on two separate treponemal tests and negative on a nontreponemal test may be candidates for treatment if they have not received treatment previously.

Top 8 At-Home Syphilis Test Kits

We've conducted thorough research to simplify your search process and compiled a list of the most dependable options available. We've taken into account factors such as:

• Convenience
• Privacy
• Cost-effectiveness
• Accuracy and reliability

Explore our recommendations for the best at-home syphilis test kits below.

LetsGetChecked Standard 5 delivers precise and confidential screening for five common STDs. Their syphilis test uses two methods – the Rapid Plasma Reagin (a non-treponemal test) and Enzyme Immunoassay (a treponemal test). This approach ensures a thorough evaluation of syphilis infection.

For $149, you can test for the following diseases:

• Chlamydia
• Gonorrhea
• HIV (I, II, P24 antigen)
• Syphilis
• Trichomoniasis

In addition to individual purchases, LetsGetChecked offers subscription plans for regular testing. Options include testing every three months (saving 30%), every six months (saving 20%), or every 12 months (saving 15%).

The process requires a blood sample, which is collected by pricking your finger using the lancet included in the kit. Upon collection, your samples are dispatched to LetsGetChecked's network of ISO and CLIA-certified laboratories. These facilities adhere to stringent quality-control procedures and undergo regular reviews to maintain standards of accuracy and reliability.

You can conveniently track your sample's transit from your home to the facility. Once received, the lab promptly notifies you, and results are typically available within 2-5 days. Results are securely delivered through an online account, granting easy access to your health information.

The dashboard presents results in a comprehensible format. Additionally, you'll receive a helpful factsheet curated by clinical experts, an official lab report, and details regarding treatment options. This ensures you have all the information needed to understand your health and take action as needed.

Pros

• Accepts FSA/HSA cards
• Comprehensive testing for five common STDs
• Confidential and secure online result delivery
• Tests conducted in ISO and CLIA-certified laboratories
• Subscription options for regular testing at discounted rates
• Access to treatment options and expert guidance
• Excellent Trustpilot ratings with over 17,000 reviews

Cons

• Not available in New York
• One user mentioned that the packaging was not discreet upon delivery

Everlywell's syphilis home test is a treponemal test that detects antibodies produced by the immune system in reaction to the bacterium Treponema pallidum. The process involves a finger prick to collect a small blood sample. At $69, their kit comes with everything you need, including:

• three lancets
• gauze
• alcohol pads
• collection card
• biohazard bag
• bandage
• prepaid return shipping label

After collecting a blood sample at home, return it to Everlywell's network of labs. Once processed, users receive an email notification informing them that their results are ready. Test results are easily accessible through an intuitive dashboard on Everlywell's platform. Typically, results are available within 5 to 7 business days after the lab processes the sample.

Pros

• HIPAA-compliant
• FSA/HSA eligible
• Free shipping
• Partnered with CLIA-certified labs
• Tests are reviewed and approved by board-certified physicians
• Abnormal results are granted access to Everlywell’s physician network for further discussion at no extra cost

Cons

• Not available in New York
• Longer waiting period

Similar to other test kits, myLAB BOX is a treponemal test that requires a blood sample to detect syphilis. Typically, results are ready within 2-5 days, and you'll be notified via email once they're available. These results are certified by the lab and can be shared with your doctor.

myLAB BOX collaborates with top laboratories and health experts. These labs hold certifications from CAP and CLIA, ensuring adherence to high testing standards. Plus, strict HIPAA web security protocols safeguard customer confidentiality, enhancing peace of mind.

Additionally, myLAB Box provides a free telemedicine consultation for positive results, discussing treatment options, and providing necessary support and guidance.

Each test kit costs $89. They also accept payment through flexible spending account (FSA) and health savings account (HSA) cards.

Pros

• Accepts payment via FSA and HSA cards
• Collaborates with certified laboratories
• Uses HIPAA-compliant web security protocols to protect customer data
• Provides a telemedicine consultation

Cons

• Not available in New York

The iDNA (I Do Need Answers) Syphilis Test kit, offered at $78, provides a convenient alternative to traditional medical appointments and laboratory visits. The test procedure employs an Enzyme-Linked Immunosorbent Assay (ELISA) to detect antibodies specific to Treponema pallidum infections using a small blood drop sample.

However, individuals previously treated for syphilis may still test positive, so this test cannot distinguish between active infections and past cured cases. ELISA is a type of Enzyme Immunoassay (EIA), making it a treponemal test.

Your iDNA syphilis test kit includes straightforward instructions for the sample collection process. Their lab result processing takes 2 to 7 days and delivers a dependable accuracy rate of 99.9%. Results are uploaded in a clear and comprehensible report format through a secure online portal.

In the event of a positive result, you can download or delete your results from the online portal at your convenience.

Pros

• Free shipping
• Affordable compared to comprehensive test kits
• Reliable results with a 99.9% accuracy rate
• Their lab partner are HIPAA-compliant, CLIA-certified, and CAP-accredited
• Discreet packaging and secure online portal for confidentiality
• Provides easy-to-follow instructions
• Access and manage your results according to your preferences

Cons

• Lacking professional guidance
• Doesn’t accept FSA/HSA payments

NURX Basics Covered STI Home Test Kit uses both urine sample and finger prick blood card collection methods and offers accurate and reliable results without the need for a clinic visit. The kit tests for four common sexually transmitted infections, including:

• HIV
• Chlamydia
• Gonorrhea
• Syphilis

With health insurance, each NURX Basics Covered STI Home test kit costs $30 for a consultation fee, $29.50 for a service fee, plus any copays or deductibles. This fee gives you unlimited access to the NURX medical team to discuss your results.

Without insurance, the kit costs $150, covering the kit, lab testing, and shipping both ways. You'll also pay a $14.50 service fee and a $30 medical consultation fee, which includes unlimited access to a NURX medical provider for help with testing, results, and follow-up care.

Once received at the partner lab, your samples undergo treponemal testing (enzyme immunoassay test). Within seven business days, the NURX medical provider team contacts you to discuss results and plan any necessary next steps.

Pros

• Accepts insurance
• Test for three other common STIs
• The consultation fee grants unlimited access to the NURX medical team
• Provides secure packaging, minimizing the risk of contamination

Cons

• Higher cost if without insurance
• Not available in New York and Rhode Island

The Verisana Comprehensive STD Test for Men, priced at $199.95, is designed to detect the presence of seven common STDs:

• HIV
• Hepatitis C
• Syphilis
• Herpes Simplex Virus Type 2
• Chlamydia
• Gonorrhea
• Trichomoniasis

Upon purchase, you'll receive sample collection kits at your doorstep. These kits contain all the necessary materials for gathering urine and blood spot samples. After collecting your samples, simply return them to the CLIA-certified partner laboratory using the enclosed pre-paid shipping label. Shipping is free, and you can expect to get your order in 5-7 days.

Unfortunately, due to legal restrictions and internal policies, Verisana is unable to process samples from residents of New York (NY), Maryland (MD), New Jersey (NJ), Rhode Island (RI), as well as any of the US Outlying Territories.

Once the lab receives and analyzes your samples, your results will be accessible on your Verisana account. The findings, including the treponemal test results, take approximately one week to complete. It will provide a comprehensive lab report explaining the analyzed markers and offering insights into potential symptoms linked to imbalances.

Pros

• Comprehensive screening for seven prevalent STDs
• Provides detailed lab reports with interpretation
• Stringent privacy measures for confidentiality
• Encourages consultation with healthcare providers

Cons

• Currently not available in NY/NJ/RI/MD

The myLAB BOX 8 Panel STD Test, also known as the Uber Box, is a comprehensive at-home testing solution that offers convenience, privacy, and peace of mind to individuals concerned about their sexual health. It costs $188.30 and tests for eight major STDs, including:

• Chlamydia
• Gonorrhea
• Hepatitis C (Hep C)
• HIV (I & II)
• Herpes Simplex 2
• Syphilis (treponemal test)
• Trichomoniasis (Trich)

The kit includes easy-to-use vaginal swabs and blood drop collection materials. Clear instructions are provided, along with video and PDF guides, to ensure accurate sample collection.

Once you've collected and returned your samples using the provided postage-paid return box, you can expect results within 3 to 5 days. This quick turnaround time helps to alleviate anxiety and allows for prompt decision-making regarding treatment, if necessary.

All testing and reporting are HIPAA-compliant. This ensures that your personal information remains confidential. If the result is positive, myLAB BOX offers free consultation services with real physicians in your state. This added support ensures you receive appropriate guidance and treatment options tailored to your needs.

Pros

• Tests for eight common STDs
• HIPAA-compliant testing
• Fast results within 3 to 5 days
• Offers free treatment consultations with real physicians for customers who tested positive

Cons

• Temporarily unavailable in NY state

LetsGetChecked Complete 8 offers one of the most extensive testing panels in the market, covering eight different infections, namely:

• Chlamydia
• Gonorrhea
• HIV (I, II, P24 antigen)
• Syphilis
• Mycoplasma
• Ureaplasma
• Trichomoniasis
• Gardnerella

Upon receipt at the lab, your samples undergo analysis employing two tests, the Rapid Plasma Reagin (a non-treponemal test) and Enzyme Immunoassay (a treponemal test). This ensures a comprehensive evaluation for syphilis infection, among other conditions.

The product arrives in discreet packaging and includes simple and user-friendly instructions for collecting samples at home. Samples are collected using non-invasive techniques such as finger prick and urine collection.

Clear instructions will be provided regarding the sample collection timing to ensure optimal accuracy and reliability of test results. Results are typically available within 2 to 5 days after the lab receives the sample.

The test kit costs $249, but customers can subscribe and save 30% every three months. This makes regular testing more affordable and accessible.

Pros

• FSA & HSA cards accepted
• Excellent Trustpilot ratings with over 17,000 reviews
• Can test for eight common infections
• Discreet packaging for privacy
• Confidential lab results with fast turnaround time
• Subscription option for cost savings
• Informative guidance on window periods and sample collection

Cons

• Not available in New York
• Higher cost compared to basic syphilis testing options
• Too comprehensive if only considering testing for syphilis

Wrap-Up

Each test kit offers unique features catering to diverse needs and preferences in at-home syphilis testing. LetsGetChecked Standard 5 stands out with its comprehensive screening for five common STDs. It’s backed by ISO and CLIA-certified laboratories to ensure precise results. Additionally, users receive informative factsheets and treatment options, further enhancing their testing experience.

Meanwhile, test kits from Everlywell, myLAB BOX, and iDNA specifically focus on testing for syphilis, making them more affordable. These kits are partnered with certified labs and ensure high testing standards and customer confidentiality.

While at-home testing can be a valuable tool for early detection and monitoring, they are not intended to replace professional medical care. A positive test result from an at-home kit should prompt individuals to seek further medical advice and treatment options from their healthcare provider.

Can I pass syphilis to my baby during pregnancy?

Yes, the infection can be transmitted to your unborn baby, a condition known as congenital syphilis. This can lead to severe health complications for the infant, such as premature birth, low birth weight, birth defects, and even stillbirth. Pregnant individuals undergo syphilis testing during their initial prenatal visit. Additionally, some may need to be retested during the third trimester (around 28 weeks gestation) and again at the time of delivery. Failure to treat syphilis in pregnant individuals can result in infant mortality in up to 40% of cases.

How soon after unprotected sex can you test for syphilis?

On average, it takes about three weeks from contracting syphilis to experiencing the initial symptoms. However, this timeframe can vary significantly, spanning from as short as ten days to as long as three months. The general recommendation from most sources is to undergo syphilis testing around 90 days after potential exposure to the infection, if asymptomatic. Testing should be conducted earlier if symptoms occur.

How accurate are at-home syphilis tests compared to traditional lab tests?

Many at-home STD testing kits claim to have an accuracy rate of 92% or higher, which is on par with laboratory testing. Moreover, a study conducted in the US determined that home-based screening is cost-saving.

Who should undergo syphilis testing?

Syphilis testing is recommended for those with symptoms or with partners who recently tested positive. Even without symptoms, sexually active individuals should discuss testing with their healthcare provider. Furthermore, healthcare providers should routinely test pregnant individuals, men who have sex with men (MSM), individuals who have HIV and are sexually active, and individuals who are using Pre-Exposure Prophylaxis (PrEP) for HIV prevention.