Figure 2. Syphilis Screening using the Reverse Algorithm for All Applicants Aged 18 Years to Those Aged less than 45 Years

Alternative Text
Top of chart begins: “Treponemal Serologic Test”
1.	If “Nonreactive treponemal Serologic Test” then “No class”
2.	If “Reactive Treponemal Serologic Test” then “Nontreponemal Serologic Test”
a.	If “Reactive Nontreponemal Serologic Test with Titers”, then “Class A Syphilis”
b.	If “Nonreactive Nontreponemal Serologic Test” then “Second Treponemal Serologic Test (preferably based on different antigens)”
i.	If “Nonreactive Second Treponemal Serologic Test” then “No class”
ii.	If “Reactive Second Treponemal Serologic Test” and
1.	“No or unknown history of prior syphilis treatment” then “Class A Syphilis”
2.	“Documented prior syphilis treatment and no concern for re-infection” then “No class”

*And any applicant aged <18 or >44 years of age suspected of having syphilis infection.