Why get tested for STDs? What to Expect?

Amy Hendel Health Guide June 08, 2009
  • Having sex? On a regular or irregular basis? Know your partner's sexual history and health status?  Are you really sure about that?  Then you need to know as much as you can about STDs.  Specifically, it's a really good idea to know what tests are available, in case you think you may have an STD.  You'll want to get the results and if you do test positive, meaning presence of an STD, you can then find out if you need to be treated (if treatment is available) and if you need to let your partner(s) know so he (or she) can be treated as well.  In some cases there is no treatment (HPV, herpes), and you may simply need to learn how not to spread the STD to others and how to minimize outbreaks..

     

    Let's agree, that the only 100% effective way to avoid STD exposure, is to refrain from sex entirely.  The next best option is to always use a condom, with the inderstanding that certain STDs like herpes, can live on skin around the vagina or penis, areas the condom will not cover. 

     

    Which STD screening tests do you need?

     

    A woman who is sexually active should have a Pap smear and gynecological exam within 3 years after her first experience with intercourse (sooner if you think you may have been exposed to an STD).  If you are age 21 and still not sexually active, you should still have your first screening done.  Cells from your cervix are collected for the Pap smear.  Doctors are looking for pre-cancerous changes that can arise from HPV (human papillomavirus).  Based on your examination and Pap smear results, your doctor will determine your future screening frequency.  If you suspect exposure to other STDs, you need to request specific testing.  Do not make the assumption that any routine testing will be done - ask about specific STD tests.

     

    Men who are sexually active do not need routine STD screening unless they suspect they were exposed to an STD or they have an ongoing homosexual relationship.  In that case, yearly screening for HIV, syphilis, chlamydia and gonorrhea might be indicated.

     

    If you see sores, fluid filled blisters or have an unusual discharge from the vagina or penis, you should see a doctor for an examination and appropriate STD screening, If you are sexually active, and between the ages of 13 and 64, experts recommend that you have at least one voluntary baseline HIV screening.  If you have unprotected sex on a regular basis, especially with more than one partner, switch partners, or have no idea of the sexual history of a partner, more frequent HIV screening may be appropriate, as well as yearly screening for gonorrhea or chlamydia.  If you test positive for gonorrhea or chlamydia, your risk of syphilis, HIV and hepatitis increases as well. 

     

    How is testing done?

    Gonorrhea and Chlamydia screening can be done on a urine sample, or through a swab inside the penis in men or from inside the cervix in women.  You can be asymptomatic which is why screening is so important.  To test for syphilis, your doctor needs a blood sample or a sample from any genital sores you might have.  HIV and syphilis testing can sometimes come back negative, if you acquired the infection recently.   

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    When it comes to herpes testing, a blood test is currently the best screening option.  There are several different types of testing and it's important to know that some blood tests do not distinguish between types 1 and 2.  You can ask for a "type-specific" IgG blood test that does differentiate between the two types.  Unfortunately, the results might not be clear, and false positives and false negatives are possible.  HPV may also present without symptoms, so as a female, you can request an HPV DNA test, which will look for low risk (non-cancer causing) HPV strains as well as high risk (cervical cancer) strains.  No HPV screening test is available for men.

     

    Insurance companies differ on coverage for screening tests, though many states have programs to ensure that all eligible women receive a screening Pap smear.