Nonpregnant adolescents and adults at increased risk for syphilis infection: USPSTF recommends?

• A. Recommends against any screening.
• B. Recommends screening only if symptomatic.
• C. Recommends screening for those at increased risk for infection.
• D. Recommends screening only in urban areas.

Answer: (C)

The main idea is that prevention relies on testing people who are more likely to have the infection, even if they feel healthy. Syphilis can be asymptomatic in its early stages, so waiting for symptoms means missing many cases. Therefore, the USPSTF recommends screening nonpregnant adolescents and adults who are at increased risk for infection. This risk-based approach targets groups such as individuals with multiple or new sexual partners, men who have sex with men, sex workers, people with a partner who has syphilis, or those in areas with higher prevalence, rather than screening everyone indiscriminately.

Screening is typically done with a serologic test—first a non-treponemal test like RPR or VDRL, followed by a confirmatory treponemal test if positive. Detecting infection early allows prompt treatment, reducing the risk of complications (like neurologic or cardiovascular involvement) and limiting transmission to others. While there can be false positives or follow-up needs, the benefits of identifying and treating infections in at-risk individuals far outweigh these downsides.