STD Tests: Which Ones Do You Need?
When it comes to STD tests, a lot of teens want them all. “Test me for everything,” they say – but that’s not really practical.
The reason is simple: There are more than 20 sexually transmitted diseases out there, and it wouldn’t make sense to do 20 different tests when you go the doctor. Instead, you get certain STD tests based on whether or not you:
are just getting a routine check-up and don’t have any symptoms
have genital bumps or sores
practice certain sexual behaviors
find out your partner has an STD
just want an HIV test
Here are some examples of each reason you might get tested for STDs:
Reason 1: It’s a Routine Check-Up, You Have No Symptoms Example: You’re a guy getting a routine check-up. 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 that case, you avoid the urethral swab altogether.
Example: You’re a girl getting a routine check-up. During the pelvic exam, you get tests for gonorrhea and chlamydia. A PAP test is done to check your cervix for signs of infection with human papilloma virus (HPV), the cause of genital warts.
And just like with guys, your urine can be tested directly for gonorrhea and chlamydia, so you can skip the pelvic exam. However, if you are due for your annual PAP test, you would still need the pelvic exam. That’s still the only way a PAP test can be done.
So why do guys and girls need routine STD tests if they’ve got no symptoms? Because gonorrhea and chlamydia very often cause silent infections – meaning you’ve got 'em and can spread 'em and not even know it.
For guys and girls:
Your genital skin can be examined for any bumps caused by genital warts or molluscum contagiosum – another virally transmitted STD.
You can get a routine HIV test.
You can get a blood test for syphilis and hepatitis C if you’ve had a lot of sexual partners.
Reason 2: You Have Symptoms (discharge from penis or vagina, pain or burning with urination) Example: You’re a girl with vaginal discharge. You need a pelvic exam to get tested for gonorrhea, chlamydia and trichomonas, 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).
Another approach – if you definitely don’t have any type of abdominal or pelvic pain – would be to use a urine test to check for gonorrhea and chlamydia. Then, a vaginal swab could be done to check for trichomonas, yeast and BV. That way, you could avoid the pelvic exam. Your doctor would have to decide if this approach is right for you.
Example:You’re a guy with painful urination or discharge from your penis. A swab from the urethra is done to check for gonorrhea and chlamydia. Or, the urine test could be done so you could skip the urethral swab.
Reason 3: You Have Genital Bumps or Sores Example: You’ve got 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’ve got a painless, firm genital ulcer. A swab from the ulcer should be checked for syphilis and herpes, and a syphilis blood test should be done.
Example:You have some genital bumps that have been around a while, and they’re cramping your style. A doctor can check them and usually tell by looking if they are genital warts or molluscum.
Reason 4: You Practice Certain Sexual Behaviors (oral sex, anal sex) Example:You’re a girl or a guy who performs oral sex on a guy, and you have a severe sore throat. A throat culture (like the one done for Strep throat) can be done to test for gonorrhea and herpes infection.
Example: You’re a guy or girl who has anal sex with guys. 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.
Reason 5: You’ve Had Many Sexual Partners Example: You’ve had 10 lifetime sexual partners – or maybe a lot more. You should get tested for gonorrhea, chlamydia, syphilis, HIV and hepatitis C.
Reason 6: Your Partner Has an STD Example: You’re a guy, and you just found out your girlfriend has trichomonas, an STD that causes a vaginal infection. You don’t really even need a test for trichomonas, since you have to be treated for it anyway or you’ll give it right back to her.
Example:You’re a girl and you find out a recent male partner of yours has 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.
Reason 7: You Just Want an HIV Test Example: You just want to make sure you’re HIV negative. You can do this with a home blood test kit or with a blood, saliva, or urine test at your doctor’s office or an HIV testing center.
So…Will You Get Tested? Fear can sometimes stop people from getting STD tests. These fears can include finding out you’ve got something, having your secrets exposed, or being rejected or discriminated against, for example. These are very real and understandable feelings.
But since the health risks of untreated STDs can be serious – to you and your partner – it makes sense to get checked out and take advantage of available treatments.
Obviously, if you’ve got any kind of genital bump or sore, or any discharge from the penis or vagina or burning when you pee, see your doctor ASAP.
But even if you don’t have symptoms, you should have a check-up and screening tests for common STDs. 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 STD test in the world. You’ll just get the ones that are right for you.