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Explore the clinical development and performance evaluation of the first over-the-counter syphilis self-test in this 37-minute conference talk from the American Society for Microbiology. Examine the historical context of syphilis diagnostics, from traditional RPR and VDRL tests developed in the 1930s-1940s to contemporary EIAs and chemiluminescent assays used as reference standards today. Learn about the ongoing global spread of Treponema pallidum and the critical need for improved screening approaches to increase test accessibility and case identification. Discover how the First to Know Syphilis Self-Test represents a breakthrough as a de novo rapid test for treponemal antibody detection, designed for over-the-counter usage. Gain insights into the clinical performance data and potential public health impact of this innovative diagnostic tool through expert discussion led by Journal of Clinical Microbiology Editor in Chief Romney Humphries and Elitza Theel. Understand how this advancement addresses the urgent need for new diagnostic approaches to combat the continuing high rates of syphilis transmission worldwide and improve treatment outcomes through enhanced case detection capabilities.