Syphilis treatment is available at sexual health clinics, local health departments, primary care offices, urgent care centers, and emergency rooms. The most accessible and affordable option for many people is a publicly funded STI clinic run by your city or county health department, where testing and treatment are often free or offered on a sliding scale based on income.
Types of Facilities That Treat Syphilis
Several types of clinics can diagnose and treat syphilis, and the right choice depends on your insurance status, budget, and how quickly you need care.
- Public STI clinics: Publicly funded STD clinics have long been the primary location for STI prevention and treatment in the United States. About 50% of local health departments directly provide STI services, and many offer testing and treatment at no cost. You can find one by searching your state health department’s website or using the CDC’s online clinic locator.
- Primary care offices: Your regular doctor can order a blood test and administer the required injection. This is the most common route for people with health insurance.
- Community health centers (FQHCs): Federally qualified health centers serve patients regardless of ability to pay and use a sliding fee scale. They’re found in every state and many accept walk-ins.
- Family planning clinics: Title X family planning clinics provide STI testing and treatment, particularly for younger and lower-income patients.
- Urgent care and emergency rooms: About 13% of people treated for syphilis received care in an emergency room, making it a viable option when other clinics aren’t available, though it’s typically the most expensive route for uninsured patients.
How to Find a Clinic Near You
The fastest way to locate a nearby option is through the CDC’s “GetTested” tool at gettested.cdc.gov, which returns free and low-cost testing and treatment sites based on your ZIP code. Your state or county health department website will also have a directory of STI clinics. Many cities have sexual health clinics that allow walk-in visits with no appointment and no insurance required.
If you’re uninsured, call ahead and ask about sliding-scale fees. The medication itself is inexpensive, typically $15 to $50 without insurance, so the main variable is the cost of the office visit and blood work.
Why You Need an In-Person Visit
Unlike some STIs that can be treated with a prescription sent to a pharmacy after a telehealth visit, syphilis requires an injection. The standard treatment is a single shot of a long-acting form of penicillin given in the muscle, usually the buttock. This means you need to physically visit a clinic or doctor’s office. A telehealth provider can order the initial blood test, but someone will need to administer the injection in person.
For early-stage syphilis (primary, secondary, or early latent), that single injection is the entire treatment. You walk in, get the shot, and the active treatment is done in one visit.
How Treatment Differs by Stage
The stage of your infection determines how many visits you’ll need. Primary and secondary syphilis, the stages where you might notice a sore or a rash, require just one injection. Early latent syphilis, where the infection is present but you have no symptoms and were infected within the past year, also requires one injection.
Late latent syphilis, meaning the infection has been present for more than a year or for an unknown duration, requires three injections given one week apart. That means three separate clinic visits over three weeks. If you’re being treated for late latent syphilis, it’s important to complete all three shots. Missing a dose may mean starting the series over.
If You Have a Penicillin Allergy
Penicillin is the only proven treatment for syphilis during pregnancy, so pregnant patients with an allergy undergo a supervised desensitization process in a medical setting before receiving the injection. For non-pregnant adults with a penicillin allergy, an alternative antibiotic given daily for about 10 days may be an option, though the CDC still considers penicillin the gold standard. If there’s any concern about whether you’ll complete the full course of an oral alternative, the recommendation is desensitization followed by the standard penicillin injection.
Treatment During Pregnancy
Syphilis during pregnancy is a medical urgency because the infection can cross the placenta and cause serious harm to the baby. Penicillin is the only antibiotic proven to treat the fetus and prevent congenital syphilis. The treatment follows the same injection protocol as for non-pregnant adults, matched to the stage of infection, but a second dose one week later is sometimes recommended for added protection, particularly when syphilis is diagnosed in the second half of pregnancy or when ultrasound shows signs of fetal infection.
What to Expect After Treatment
After receiving the injection, you’ll need follow-up blood tests to confirm the treatment worked. These are typically scheduled at 6 and 12 months after treatment. The blood test measures your antibody levels, and a successful treatment shows those levels dropping over time. If they don’t decline as expected, retreatment with three weekly injections may be necessary.
Some people experience a reaction within the first 24 hours after the injection, with symptoms like fever, chills, headache, and muscle pain. This is a known response to the bacteria dying off and usually resolves on its own within a day. It’s more common in early-stage syphilis when the bacterial load is higher.
Notifying Partners
Sexual partners need to be tested and potentially treated. Expedited partner therapy, where you deliver medication to a partner without them being examined first, is legally permitted in 48 states and Washington, D.C., though it was designed primarily for chlamydia and gonorrhea. Because syphilis treatment requires an injection rather than an oral pill, partners generally need their own clinic visit. Many public health departments offer partner notification services where a staff member contacts your partners confidentially so you don’t have to do it yourself.