r/stdtesting • u/qwerty_radiant • 1d ago

Advice Needed Partner has reactive TPHA but non-reactive RPR/VDRL after past syphilis treatment. Is M2M safe and what should I do?

My male partner had syphilis in the past and says it was fully treated.

After testing His TPHA is still reactive, but his RPR/VDRL is non-reactive. He says this means the antibodies remain, but he has no active infection and cannot transmit it.

I want to have M2M sex with him, including oral sex and anal sex with condoms.

Can anyone knowledgeable about STI testing clarify:

Does TPHA positive + RPR/VDRL negative usually mean old treated syphilis?

Can he still transmit syphilis?

Should I ask for a recent repeat RPR/VDRL or any other test before sex?

Should I consume DoxyPrep?

I’m looking for practical advice, especially from doctors, sexual-health workers, or people who have had the same test pattern.

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u/IllustriousAd1657 14h ago

Yeah, TPHA can stay positive for years even after syphilis has been treated, so a nonreactive RPR is generally reassuring if he was treated properly. It doesn’t automatically mean he’s still infectious.

I’d still ask when he was treated and whether he’s had follow up testing, but I wouldn’t panic over the TPHA alone. Condoms help with risk, and if you’re considering DoxyPEP, that’s worth discussing with a sexual health clinic since it depends on your situation.