If you're sexually active, especially with multiple partners, you've probably heard the following advice many times: Use protection and get tested.
This is important because a person can have a sexually transmitted disease (STD) without knowing it. In many cases, there aren't any signs or symptoms. In fact, that's why many experts prefer the term sexually transmitted infections (STIs), because you can have an infection without disease symptoms.
But what types of STI testing do you need? And how often should you be screened? The answers depend on your age, your sexual behaviors and other risk factors.
Don't assume that you're receiving STI testing every time you have a gynecologic exam or Pap test. If you think that you need STI testing, request it from your doctor. Talk to your doctor about your concerns and what tests you'd like or need.
See these guidelines for STI testing for specific sexually transmitted infections (STIs).
National guidelines recommend that you get screened annually if:
Doctors screen people for chlamydia and gonorrhea by taking a urine test or a swab inside the penis in men or from the cervix in women. The sample is then analyzed in a lab. Screening is important, because if you don't have signs or symptoms, you may not know that you have either infection.
The Centers for Disease Control and Prevention (CDC) encourages HIV testing, at least once, as a routine part of medical care if you're an adolescent or adult between the ages of 13 and 64. Younger teens should be tested if they have a high risk of an STI. The CDC advises yearly HIV testing if you're at high risk of infection.
The CDC recommends hepatitis C screening for everyone born between 1945 and 1965. The incidence of hepatitis C is high in this age group, and the disease often has no symptoms until it's advanced. Vaccines are available for both hepatitis A and B if screening shows you haven't been exposed to these viruses.
National guidelines recommend that you request testing for HIV, syphilis and hepatitis if you:
Your doctor tests you for syphilis by taking either a blood sample or a swab from any genital sores you might have. The sample is examined in a lab. A blood sample is taken to test for HIV and hepatitis.
No good screening test exists for herpes — a viral infection. Most people with herpes infection never have any symptoms but can still transmit the virus to others. Your doctor may take a tissue scraping or culture of blisters or early ulcers, if you have them, to be examined in a lab. But a negative test doesn't rule out herpes as a cause for genital ulcerations.
A blood test also may help detect a past herpes infection, but results aren't always definite. Some blood tests can help differentiate between the two main types of the herpes virus. Type 1 is the virus that more typically causes cold sores, although it can also cause genital sores.
Type 2 is the virus that causes genital sores more often. Still, the results may not be totally clear, depending on the sensitivity of the test and the stage of the infection. False-positive and false-negative results are possible.
Certain types of human papillomavirus (HPV) can cause cervical cancer while other varieties of HPV can cause genital warts. Many sexually active people become infected with HPV at some point in their lives, but never develop symptoms. The virus typically disappears within two years.
There's no routinely used HPV screening test for men, in whom the infection is diagnosed by visual inspection or biopsy of genital warts. In women, HPV testing involves:
HPV has also been linked to cancer of the vulva, vagina, penis, anus, and mouth and throat. Vaccines can protect both men and women from some types of HPV, but they are most effective when administered before sexual activity begins.
At-home test kits for certain STIs, such as HIV, chlamydia and gonorrhea, have been gaining acceptance and popularity. For home STI testing, you collect a urine sample or an oral or genital swab and then send it to a lab for analysis.
Some tests require more than one sample. The benefit of home testing is that you're able to collect the sample in the privacy of your home without the need for a pelvic exam or office visit.
However, tests done on samples you collect yourself may have a higher rate of false-positive results, meaning that the test indicates you have an STI that you really don't have. If you test positive from a home test, contact your doctor or a public health clinic to confirm the test results. If your home test results are negative, but you're experiencing symptoms, contact your doctor or a public health clinic to confirm the results.
If you test positive for an STI, the next step is to consider further testing and then get treatment as recommended by your doctor. In addition, inform your sex partners. Your partners need to be evaluated and treated, because you can pass some infections back and forth.
Expect to feel many emotions. You may feel ashamed, angry or afraid. It may help to remind yourself that you've done the right thing by getting tested so that you can inform your partners and get treated. Talk with your doctor about your concerns.