Syphilis screening: who should get tested and how often

When it starts, when it can stop

Starts: At 18 in this planner (the recommendation also covers adolescents), for people at increased risk. (USPSTF, 2022)
Can stop: No upper age limit while the risk continues. (USPSTF, 2022)

Who it is for

Nonpregnant adolescents and adults who have ever been sexually active and are at increased risk for syphilis. (USPSTF, 2022)

In My Screening Plan this shows under "Also ask your doctor about" for everyone in the age range. The planner does not ask about these risk factors, so nothing about them is entered or stored.

Test and how often

A blood test, confirmed with a second type of syphilis test if it is positive. (USPSTF, 2022)
Evidence on intervals is limited. Men who have sex with men and people with HIV may benefit from testing at least once a year, or every 3 to 6 months while they stay at high risk. (USPSTF, 2022)

Syphilis testing: who and how often

Syphilis screening by group: USPSTF 2022 and 2025, CDC STI Treatment Guidelines 2021
Who	USPSTF	CDC (2021)
Adults and teens at increased risk	Screen (A, 2022); no set interval	Screen women and men who have sex with women at increased risk
Men who have sex with men	Screen (A, 2022); may benefit from at least yearly, or every 3 to 6 months at high risk	At least yearly; every 3 to 6 months at increased risk
People with HIV	Screen (A, 2022); may benefit from at least yearly, or every 3 to 6 months at high risk	At the first HIV visit, then at least yearly if sexually active
Pregnant people	Screen all, early in pregnancy (A, 2025)	All at the first prenatal visit; retest at 28 weeks and at delivery if at increased risk
People not at increased risk	No recommendation to screen	No routine screening

The two broadly agree. The CDC is more specific on timing, and also advises considering yearly screening for transgender and gender diverse people based on sexual behavior and exposure. (USPSTF, 2022) (CDC, 2021)

Ask your doctor whether you need a test and how often.

Where the USPSTF draws the line

Grade C means a small net benefit, so it is offered to some people; D means do not screen; I means the evidence is not enough to decide. (USPSTF grade definitions)

Pregnancy is covered by a separate grade A statement (May 13, 2025): screen everyone early in pregnancy, or at the first chance if that was missed. (USPSTF, 2022)

Questions people ask

Who is at increased risk for syphilis?

The USPSTF lists men who have sex with men; people with HIV or another sexually transmitted infection; people who use illicit drugs; and people with a history of incarceration, sex work or military service. It also asks clinicians to consider how common syphilis is in their community. (USPSTF, 2022)

How often should you get a syphilis test?

For most people the USPSTF says evidence on intervals is limited. Men who have sex with men and people with HIV may benefit from screening at least once a year, or every 3 to 6 months if they stay at high risk. (USPSTF, 2022)

What test is used?

A blood test. One type of syphilis test is used first, and a positive result is confirmed with the other type (the USPSTF describes a traditional and a reverse order). (USPSTF, 2022)

Should I get a syphilis test if I am pregnant?

Yes. The USPSTF recommends early screening for all pregnant people (grade A, 2025), and the CDC advises a test at the first prenatal visit, with retests at 28 weeks and at delivery for those at increased risk. (USPSTF, 2025) (CDC, 2021)

How often should gay and bisexual men get a syphilis test?

The CDC advises at least once a year for sexually active men who have sex with men, and every 3 to 6 months for those at increased risk. The USPSTF says they may benefit from a similar schedule. (CDC, 2021) (USPSTF, 2022)

Does Medicare cover syphilis testing?

Medicare Part B covers one STI screening for chlamydia, gonorrhea, syphilis and hepatitis B every 12 months if you are at increased risk (or at certain times in pregnancy), when your provider orders it. You pay nothing if your primary care provider accepts assignment. (Medicare.gov)

Source

U.S. Preventive Services Task Force, "Syphilis Infection in Nonpregnant Adolescents and Adults: Screening", final recommendation released September 27, 2022. Read it on uspreventiveservicestaskforce.org. Checked against the live page on 2026-10-28.