When it comes to sexually transmitted infection (STI) tests, a lot of people want them all. “Test me for everything,” they might say — but most of the time, that’s not really practical.
The reason is simple: There are more than 25 different types of STIs (also called sexually transmitted diseases, or STDs) out there, and it wouldn’t make sense to do 25 different tests when you go the doctor. Instead, you get certain STI tests based on certain factors, including whether you:
- are just getting a routine check-up and don’t have any symptoms
- have symptoms, such as genital bumps or sores
- practice certain sexual behaviors
- find out your partner has an STI
- just want a human immunodeficiency virus (HIV) test
General STI testing guidelines
The Centers of Disease Control and Prevention (CDC) lists the following general STI testing recommendations:
People ages 13 to 64 should be tested for HIV at least once.
Sexually active women younger than 25 and older women with certain risk factors (new or multiple sex partners or a sex partner with an STI) should be tested once a year for chlamydia and gonorrhea.
All pregnant women should be tested for syphilis, HIV, and hepatitis B.
At-risk pregnant women should be tested for chlamydia and gonorrhea early in pregnancy. Repeat testing should be done as needed.
All sexually active men who have sex with men should be tested at least yearly for chlamydia, gonorrhea, and syphilis. Men who have sex with men and have multiple or anonymous partners should get tested more frequently.
Sexually active gay and bisexual men may consider more frequent HIV testing.
People who have unsafe sex or share injection drug equipment should get tested for HIV at least yearly.
Why do people need STI tests if they have no symptoms?
Some STIs, like gonorrhea and chlamydia, often cause silent infections — meaning you can have them and infect others and not even know it. That’s why it’s important to be tested regularly according to CDC guidelines, even if you don’t think you have an STI.
Common STI testing scenarios
Still not sure what STIs fit your specific situation? Here are some examples of reasons you might get tested for STIs:
Example: It’s a routine check-up, and you have no symptoms
You’re getting a routine check-up. If you're male, your urine can be checked for leukocytes (white blood cells), which could mean an infection with gonorrhea or chlamydia. To be sure, you get a urethral swab to make the diagnosis.
Or, if the test is available to your doctor, your urine itself gets tested for gonorrhea and chlamydia with new tests called nucleic acid amplification tests. In this case, you avoid the urethral swab altogether.
If you're female and getting a routine check-up, you'll get tests for gonorrhea and chlamydia during the pelvic exam. A Pap test is done to check your cervix for signs of cervical cell changes caused by human papillomavirus (HPV) infection.
And just like with men, your urine can be tested directly for gonorrhea and chlamydia, so you can skip the pelvic exam if those are the only tests you are getting. However, if you are due for your annual Pap test, you would still need the pelvic exam.
Example: You have abnormal symptoms
If you’re female and have abnormal vaginal discharge. You may need a pelvic exam to get tested for STIs like gonorrhea, chlamydia, and trichomoniasis, and for other causes of discharge like yeast infections and bacterial vaginosis (BV). The pelvic exam also checks for pelvic inflammatory disease (PID), an infection of your internal reproductive organs (uterus, fallopian tubes, ovaries) that can be caused by untreated STIs.
If you’re male and have painful urination or discharge from your penis, a swab from the urethra is done to check for gonorrhea and chlamydia. A urine test may also be done.
Or maybe you have some nasty genital ulcers that hurt. A swab from an ulcer should be tested for herpes. A blood test for syphilis should also be done.
Example: You practice certain sexual behaviors (oral sex, anal sex)
Say you perform oral sex on someone, and you have a severe sore throat. A throat culture (like the one done for Strep throat) can be done to test for gonorrhea infection.
If you have anal sex with men, you should definitely have an HIV test. Tests for rectal infections and other infections like hepatitis B and hepatitis C can be done based on your individual situation.
Example: Your partner has an STI
Perhaps you've found out that your recent sexual partner has been diagnosed with gonorrhea. Even if you don’t have any symptoms, you need to be tested for gonorrhea and chlamydia — since the two like to travel together — and be treated for both.
Fear of getting tested for STIs
Fear and anxiety can sometimes stop people from getting STI tests. These fears can include finding out you’ve got something, having your secrets exposed, or being rejected or discriminated against if other people find out you have an STI. These are very real and understandable feelings.
But because the health risks of untreated STIs can be serious to you and your partner, it’s important to get tested.
In women, one long-term repercussion of not treating STIs include infertility, and if you do get pregnant, you may pass the STI to your baby during pregnancy or childbirth, causing health problems in your baby, according to the American Sexual Health Association. Other risks include developing PID or cervical cancer.
In men, untreated STIs can also cause infertility. Further, untreated gonorrhea can infect the joints, and HPV can increase your risk of developing cancer. It makes sense to get checked out and take advantage of available treatments.
Even if you don’t have symptoms, you should have regular check-ups and screening tests for common STIs. That way, you can receive counseling and treatment for any silent infections that get uncovered. You can also review safer sexual practices with your doctor or health provider.
Remember: You won’t need — or get — every STI test in the world. You’ll just get the ones that are right for you.