What Is the RPR Test?

The Rapid Plasma Reagin (RPR) test is a non-treponemal serological screening test for syphilis. It detects antibodies that the body produces in response to syphilis infection. The RPR is a standard, widely used screening method and is the test required by USCIS for the immigration medical examination.

Who Is Required to Have Syphilis Testing?

Syphilis serology (RPR) is required for all immigration medical exam applicants age 15 and older. Applicants under age 15 are not required to undergo syphilis testing as part of the standard USCIS laboratory panel.

Understanding RPR Results

RPR results are reported as either non-reactive (negative) or reactive (positive), along with a titer value for reactive results. A non-reactive result indicates no evidence of current or past syphilis infection.

A reactive RPR result does not automatically mean you have active syphilis. The RPR can be reactive due to past treated syphilis, biological false positives (caused by other conditions such as pregnancy, autoimmune diseases, or certain infections), or active syphilis infection. A reactive RPR always requires confirmatory treponemal testing.

Confirmatory Testing for Reactive RPR

If your RPR is reactive, your Civil Surgeon will order a confirmatory treponemal test — either the Fluorescent Treponemal Antibody Absorption (FTA-ABS) test or the Treponema pallidum Particle Agglutination (TP-PA) test. A reactive confirmatory test confirms syphilis infection (current or past). A non-reactive confirmatory test indicates a biological false positive RPR, which does not affect your immigration case.

What a Confirmed Positive Means for Your Case

Active, untreated syphilis is a Class B communicable disease of public health significance. It is not a Class A condition (which would be a ground of inadmissibility), but it must be documented and addressed on Form I-693.

If you have a history of treated syphilis with documented cure, this does not prevent green card approval. Your Civil Surgeon will document the treatment history on Form I-693. If active syphilis is identified, treatment must be completed and documented before the I-693 can be finalized.

How Results Are Documented on Form I-693

Syphilis testing results are documented in Part 4 of Form I-693 (Syphilis Serology). Your Civil Surgeon records the RPR result, titer value, and confirmatory test results if applicable. The completed form is sealed and submitted to USCIS — you receive a copy for your records.