Syphilis Titers and Partner Management: Practical Guidance for Primary Care, With Kathryn Miele, MD

Syphilis testing and follow-up can present persistent challenges in primary care, particularly when clinicians are faced with low titers, discordant results, incomplete patient histories, or uncertainty around prior treatment. At the 2026 American College of Obstetricians and Gynecologists Annual Clinical & Scientific Meeting, held May 1-3, in Washington, DC, Patient Care Online spoke with Kathryn Miele, MD, medical officer at the Centers for Disease Control and Prevention in the Prenatal Exposure Surveillance and Research Team, about practical approaches to syphilis management for frontline clinicians.

In the following interview, Miele discusses why taking time to interpret difficult titer results can help clinicians build confidence and improve future decision-making. She also highlights available support resources, including the STD Clinical Consultation Network and local health departments, which can help clinicians clarify patient histories, interpret results, and determine next steps in care.

Miele also reviews practical considerations for partner management, including when sex partners of patients with early syphilis may be presumptively treated and how clinicians can approach treatment when follow-up may be unreliable. Her remarks underscore the role of primary care clinicians in recognizing syphilis, acting quickly on uncertain results, and helping close gaps in testing, treatment, and partner services.