Why the New OTC Syphilis Test Will Especially Benefit People 55+
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Photo Illustration by Amelia Manley for Verywell Health; NOWDiagnostics
Fact checked by Nick BlackmerFact checked by Nick Blackmer
Key TakeawaysA new OTC syphilis test will soon be available in the U.S.Syphilis cases have increased seven-fold in older adults over the past decade.Testing at home can help patients stay informed about their status.
The Food and Drug Administration (FDA) has granted marketing authorization for the first at-home, over-the-counter syphilis test. The First To Know Syphilis Test allows people to test for the sexually transmitted infection from home. Previously, they needed to see a doctor for testing.While the test will soon be available to everyone, infectious disease doctors say it may be particularly helpful for older adults. Data show that cases of sexually transmitted infections (STIs), including syphilis, are skyrocketing in people 55 and up.Here’s what the test involves, plus how it can be helpful to this age group.How Does the Test Work?The First To Know Syphilis Test looks for syphilis antibodies in the blood. To use the test, a patient will use an included lancet, prick their finger, and apply a drop of blood to the testing device.After 15 minutes, they should get results that indicate whether or not they have syphilis antibodies.The FDA notes that the test should be followed by additional testing guided by a physician to confirm a syphilis diagnosis. The test is expected to be available later in 2024, according to the manufacturer.Why Might the Tests Benefit Older Adults?There’s a couple of reasons that this at-home test is a win for older adults.Increasing STI RatesRates of syphilis in adults aged 55 and up have increased seven-fold between 2012 and 2022, according to data from the Centers for Disease Control and Prevention (CDC).“Older adults are at risk for syphilis the same way younger people are at risk for syphilis—through sexual activity,” infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security, told Verywell.This isn’t something that all doctors keep top of mind, Zachary Shepard, MD, assistant professor of medicine and infectious disease at the Baylor College of Medicine, told Verywell.“Despite our knowledge that sex is an important part of maintaining healthy relationships and the medical advances have allowed people to maintain their sex lives well into advanced age, older patients who are sexually active and at risk for syphilis may not be offered appropriate screening,” he said.Having an easily accessible home test for syphilis may help pick up on these cases that would otherwise go undiagnosed.Latent Syphilis InfectiousSyphilis can be difficult to detect when a person isn’t testing for it.“Most patients think of syphilis as an infection that causes obvious and immediate symptoms. However, the majority of cases that are diagnosed are found when the infection is in an asymptomatic period that we call ‘latency,’” Shepard said.If left untreated, syphilis can cause symptoms years later like ulcers, rashes, liver inflammation, damage to the body’s major blood vessels, and even neurologic diseases of the central nervous system, including strokes and blindness, Shepard said.“Syphilis at any stage is easily curable, but the damage it can cause when left untreated can be permanent and life-altering,” he said. “Latency periods where the infection lays dormant can last for decades, so even older patients who may not have had sexual activity for years should be screened to make sure they are not at risk for complications from syphilis down the road. An infection acquired in someone’s 30s, left untreated, can still cause damage when they are in their 70s.”Lack of Insurance CoverageFor adults who are 65 and older and on Medicare, syphilis testing is only covered if you meet certain health requirements—though one of those requirements is simply being “at increased risk for STIs annually.”If you’re struggling to get testing cleared by a healthcare provider or insurance company, a $30 OTC test could be a good option.If testing is covered by Medicare, Adalja points out that STIs are often tested as part of a panel—not just one test looking for a specific infection. You likely won’t be able to test for syphilis alone.“Many STIs travel together, so often they are performed as a panel to rule out co-infections,” he said.That doesn’t mean there isn’t value in a syphilis test, though. “Patients do sometimes request testing for specific sexually transmitted infections like syphilis,” Shepard said. “This used to occur mainly if a patient had a specific concern following an exposure or event. But increasingly, we are seeing patients requesting screening as a proactive step following something they saw in a public education campaign or an article published in the news.”Shepard stresses that everyone who is sexually active should be on top of their sexual health.“Sexual health is important for everyone, regardless of age,” he said. “Testing is fast and easy, and knowing one’s status with respect to things like syphilis, gonorrhea, chlamydia, HIV, and hepatitis B and C is the best way to protect both yourself and the people you care about.”
What This Means For YouA home test for syphilis should be available over the counter within the next few months. If you’re concerned about syphilis now, bring it up to your healthcare provider or reach out to a sexual health clinic about next steps.
Read the original article on Verywell Health.
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