Hi there. I read your history with interest. Yes it is possible to get a positive TPHA & a negative RPR (VDRL). However, like i stressed on another public forum query, this has to be interpreted with caution & taking the individual case history & clinical features in consideration. To begin with, the VDRL can be negative simply because of the antigenic load. This can be confirmed by doing the test in high dilutions . Also, it may turn up false negative. It is not a very sensitive test..in that it may detect a lot more than it excludes but based on this, a definitive treatment cannot be made. Very commonly long standing fevers etc can easily manifest as VDRL positive & then one is in a quandry. What it does supply when positive is a guide (albeit not always reliable) to progress of treatment. The TPHA test too can manifest with both false positivity or negativty. I understand this must be all confusing for the ordinary person &believe me even dermatologists & immunologists consider this an academic graveyard ! In your case, the best advice i can give you is stick with your dermatologist/venereologist on the ground. When in doubt, a TPI test is mre relevant (treponema pallidum immobilization test) &/or a FTA-Abs test (immunoflorescent treponema antibodies if this facility available near you at a large centre). If none available, i would recommend using the age-old tried & trusted 28 day regime of a safe Erythromycin tabs to treat as for secondary syphilis (given your time frame & h/o multiple exposures). I find erythropmycin both a safe & effective alternative to penicillin mainly because of something known as the Jarisch Herxheimer reaction which believe me is something you dont want to take a risk with...& the details are too long to go into on a public forum! Trust all your questions stand answered & wish you a quick recovery & safe health..& Please do practice Safe Sex..whatever the variety you should choose to indulge in. Cheers & Good Luck! Dr Praveen Rodrigues MD Dermatologist, Cosmetologist, Venereologist Vikram Hospital, Bangalore, India.