Sexually Transmitted Infections - Should I Get Tested?
If you're asking this question, you probably know the answer.
All kidding aside, there is a lot of confusion about who should get tested for STIs and what infections are part of standard testing.
April is STD* awareness month and here's what you need to know:
If you answer YES to any of the questions below - you should get tested**:
Are you under age 25 and have not been tested in the last year?
The CDC recommends that all women 24 and younger get tested for chlamydia and gonorrhea EVERY YEAR, regardless of other risk factors.
Were you recently treated for chlamydia or gonorrhea?
You should be retested 3 months after treatment because of increased risk of re-infection
Do you have a new sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has a sexually transmitted infection?
Are you a woman aged 13-64?
You should be tested for HIV at least once and more often depending on risk factors.
Are you pregnant?
All pregnant women should routinely be screened for HIV, syphilis and Hepatitis B at the first prenatal visit and additional times during pregnancy or at delivery if high risk
If you're under 25, you should be tested for chlamydia and gonorrhea at the first prenatal visit and again in the 3rd trimester.
You say: "Test me for everything". What does that mean to your doctor?
Here is the standard panel for STI screening in women without symptoms.
Chlamydia and Gonorrhea - can be tested through urine or a vaginal swab you insert yourself or by a provider during a pelvic exam. Depending on your sexual practices, your healthcare provider might also recommend testing for rectal or throat infection.
HIV - blood test
These tests are not included in routine screening for STIs unless you have symptoms or specific risk factors:
Herpes - the blood test for Herpes only shows whether you've been exposed - not whether you actually have herpes. And it is even more confusing than that because there are two types of Herpes - 1 and 2. It used to be that 1 was only oral herpes (cold sores) and 2 was the genital form. However, some genital infections can also be caused by Type 1. The best test for herpes is a swab of an active sore.
Human Papilloma Virus (HPV, aka warts) - there are two main types of HPV - low risk and high risk. The low risk types cause warts and the high risk types can cause pre-cancerous changes in the cervix or cervical cancer. We usually check for HPV at the same time as the pap smear - particularly if they find any changes in the cells of your cervix that indicate you might have the high risk type. Warts are easy to spot and usually don't require testing.
Trichomonas - this is a vaginal infection that causes frothy vaginal discharge and irritation. There is no standard screening test for this and it is usually symptomatic so providers can test for this by taking a sample of your vaginal discharge if they see signs during the exam.
Hepatitis B or C (blood tests) - these are not commonly spread through sexual activity but certain groups at high risk should be tested. Ask your doctor if you're not sure.
Syphilis (blood test) - although this infection has been on the rise in the US, routine screening in women is not currently recommended by CDC except in pregnancy and for those with HIV. Your doctor may want to screen for syphilis based on risk factors or symptoms.
*STD=sexually transmitted disease - this implies symptoms and has fallen out of common use due to the fact that many infections don't have symptoms and because of the stigma associated with the word "disease"
**These are screening guidelines for those who are biologically women (based on anatomical risk factors). For additional screening recommendations for men, men who have sex with men and those with HIV, check out the STD Screening Recommendations from the CDC or contact your healthcare provider.