Syphilis Testing Is Required for All Applicants

Syphilis testing is a mandatory component of the immigration medical exam for all applicants 15 years of age and older. The test is performed via a blood draw and is safe during pregnancy. A positive result triggers a specific protocol that the civil surgeon must follow under USCIS guidelines.

A reactive syphilis screening test (such as RPR or VDRL) is followed by a confirmatory treponemal test. If both are reactive, the civil surgeon will classify the finding and initiate the referral process for treatment.

What Happens After a Positive Result During Pregnancy

If your syphilis test is positive during pregnancy, the civil surgeon will:

• Document the reactive result on Form I-693
• Classify the finding as a Class B condition (communicable disease of public health significance)
• Refer you to a treating physician or public health department for evaluation and treatment
• Advise you that Form I-693 cannot be finalized until treatment is completed and documented

Treatment During Pregnancy

Syphilis treatment during pregnancy is both safe and effective. The standard treatment is penicillin G, which is the only antibiotic proven to treat syphilis in pregnant women and prevent transmission to the fetus. If you have a penicillin allergy, your treating physician will discuss desensitization options — alternative antibiotics used in non-pregnant adults are not recommended during pregnancy.

Treatment is typically administered by your OB-GYN, a public health clinic, or an infectious disease specialist. The treating physician will provide documentation of the treatment, which the civil surgeon needs to update Form I-693.

Early treatment is important during pregnancy because untreated syphilis can cause serious complications for the fetus, including stillbirth, premature birth, and congenital syphilis. Treating syphilis promptly protects both you and your baby.

How It Is Documented on Form I-693

The civil surgeon will document the reactive syphilis finding on Form I-693 as a Class B condition. Once you complete treatment and provide documentation from your treating physician, the civil surgeon will update the form to reflect the completed treatment.

USCIS will review the documentation as part of your application. A treated syphilis finding does not automatically result in denial of your green card application. USCIS evaluates the documentation to confirm that the condition was properly treated and is no longer a public health concern.

Does a Positive Syphilis Test Affect My Green Card Application?

A positive syphilis result that has been properly treated and documented does not automatically disqualify you from receiving a green card. USCIS is primarily concerned with whether communicable diseases of public health significance are being appropriately managed. Completing treatment and providing documentation to the civil surgeon is the key step. Consult your immigration attorney if you have concerns about how this finding may affect your specific case.