STD testing: What's right for you?

If you're sexually active, particularly with multiple partners, you've probably heard the following advice many times: Use protection and make sure you get tested. This is important because people can have a sexually transmitted disease (STD) without knowing it. In many cases, no signs or symptoms occur.

But what types of STD testing do you need? And how often should you be screened? The answers depend on your age, your sexual behaviors and other risk factors.

If you're a woman, don't assume that you're receiving STD testing every time you have a gynecologic exam or Pap test. Regardless of your gender and age, if you think you need STD testing, request it from your doctor. Talk to your doctor about your concerns and mention specifically what infections you think you might have.

Testing for specific STDs

Here are some guidelines for STD testing for specific sexually transmitted diseases.

Chlamydia and gonorrhea
Get screened annually if:

• You're a sexually active girl or woman under age 25
• You're a woman older than 25 and at risk of STDs — for example, if you're having sex with a new partner or multiple partners
• You're a man who has sex with men

Chlamydia and gonorrhea screening is done either through a urine test or through a swab inside the penis in men or from the cervix in women. The sample is then analyzed in a laboratory. Screening is important, because if you don't have signs or symptoms, you can be unaware that you have either infection.

HIV, syphilis and hepatitis
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. The CDC advises yearly HIV testing if you are at high risk of infection.

Request testing for HIV, syphilis and hepatitis if you:

• Test positive for gonorrhea or chlamydia, which puts you at greater risk of other STDs
• Have had more than one sexual partner since your last test
• Use intravenous (IV) drugs
• Are a man who has sex with men

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 laboratory. A blood sample is taken to test for HIV and hepatitis.

Genital herpes
No good screening test exists for herpes, a viral infection that can be transmitted even when an infected person doesn't have symptoms. Your doctor may take a tissue scraping or culture of blisters or early ulcers, if you have them, for examination in a laboratory. But a negative test doesn't rule out herpes as a cause for genital ulcerations.

A blood test also may help detect a herpes infection, but results aren't always conclusive. 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 more typically causes genital sores. 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.

HPV
Certain types of human papillomavirus (HPV) can cause cervical cancer while other varieties of HPV can cause genital warts. Most sexually active people become infected with HPV at some point in their lives, but never develop symptoms. The virus typically disappears within two years.

No HPV screening test is available for men, in whom the infection is diagnosed only by visual inspection or biopsy of genital warts. In women, HPV testing involves:

• Pap test. Pap tests, which check the cervix for abnormal cells, are recommended every two years for women between ages 21 and 30. Women age 30 and older can wait three years between Pap tests if their past three tests have been normal.
• HPV test. Samples for the HPV test are collected from the cervical canal. This test usually isn't offered to women younger than 30 because HPV infections that will ultimately clear up on their own are so common in this age group.

HPV has also been linked to cancer of the vulva, vagina, penis and anus. 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 STD testing

Gaining acceptance and popularity are at-home test kits for certain STDs, such as chlamydia and gonorrhea. For home STD testing, you collect a urine sample or a genital swab and then send it to a laboratory for analysis. Some tests require both types of samples. You can usually get test results in a few days, and you're able to collect the sample in the privacy of your home without 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 the test indicates you have an STD 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.

Positive test results

If you test positive for an STD, the next step is to consider further testing and then to 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 various 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.

Related

• Genital herpes: Can you get it from a toilet seat?
• Gonorrhea
• Genital warts
• Syphilis
• Chlamydia
• Trichomoniasis
• Genital herpes
• Condoms
• Female condom
• Infertility
• Infectious diseases
• STD symptoms: Common STDs and their symptoms
• Sexually transmitted diseases (STDs)