According to estimates from the Centers for Disease Control and Prevention (CDC), about 20 million new sexually transmitted infections (STIs) occur each year in the United States. These infections are often called sexually transmitted diseases (STDs). If left untreated, they can cause severe health problems, including:
- organ damage
Unfortunately, many people don’t receive prompt treatment for STIs. Many STIs have no symptoms or very nonspecific symptoms, which can make them hard to notice. The stigma around STIs also discourages some people from getting tested. But testing is the only way to know for sure if you have an STI.
Talk to your doctor to learn if you should be tested for any STIs.
If you’ve been sexually active, it’s a good idea to be tested for STIs. It’s especially important to get tested if:
- you’re about to begin a new relationship
- you and your partner are thinking about not using condoms
- your partner has cheated on you or has multiple partners
- you have multiple partners
- you have symptoms that suggest you might have an STI
If you’re in a long-term, mutually monogamous relationship, and both you and your partner were tested before entering the relationship, you may not need regular STI testing. But many people in long-term relationships weren’t tested before they got together. If that’s the case for you and your partner, it’s possible that one or both of you have been carrying an undiagnosed STI for years. The safest choice is to get tested.
There are a number of different STIs. To learn which ones you should be tested for, talk to your doctor. They may encourage you to be tested for one or more of the following:
Your doctor probably won’t offer to test you for herpes unless you have a known exposure or ask for the test.
Ask your doctor
Don’t assume that your doctor will automatically test you for all STIs at your annual physical or sexual health check-up. Many physicians don’t regularly test patients for STIs. It’s important to ask your doctor for STI testing. Ask which tests they plan to do and why. It’s important to get tested if you’ve been forced to have intercourse. You should also get screened if you’re pregnant, as STIs can have an effect on the fetus.
Taking care of your sexual health is nothing to be shy about. If you’re concerned about a particular infection or symptom, talk to your doctor about it. The more honest you are, the better treatment you can receive.
Discuss your risk factors
It’s also important to share your sexual risk factors with your doctor. In particular, you should always tell them if you engage in anal sex. Some anal STIs can’t be detected using standard STI tests. Your doctor might recommend an anal Pap smear to screen for precancerous or cancerous cells, which are linked to the human papillomavirus (HPV).
You should also tell your doctor about:
- the types of protection you use during oral, vaginal, and anal sex
- any medications you’re taking
- any known or suspected exposures you’ve had to STIs
- whether you or your partner have other sexual partners
You may receive testing for STIs at your regular doctor’s office or a sexual health clinic. Where you go is a matter of personal preference.
Several STIs are notifiable diseases. That means your doctor is legally required to report positive results to the government. The government tracks information about STIs to inform public health initiatives. Notifiable STIs include:
At-home tests and online tests are also available for some STIs, but they aren’t always reliable. Check to make sure the Federal Drug Administration (FDA) has approved any test you buy.
Depending on your sexual history, your doctor may order a variety of tests to check you for STIs, including blood tests, urine tests, swabs, or physical exams.
Blood and urine tests
Most STIs can be tested for using urine or blood samples. Your doctor can order urine or blood tests to check for:
In some cases, urine and blood tests aren’t as accurate as other forms of testing. It may also take a month or longer after you’re exposed to certain STIs for blood tests to be reliable. If you contract HIV for example, it can take a couple of weeks to a few months for tests to detect the infection.
Many doctors also use vaginal, cervical, or urethral swabs to check for STIs. If you’re female, they can use a cotton applicator to take vaginal and cervical swabs during a pelvic exam. If you’re male or female, they can use take urethral swabs by inserting a cotton applicator into your urethra. If you have anal sex, they may also take a rectal swab to check for infectious organisms in your rectum.
Pap smears and HPV testing
Strictly speaking, a Papanicolaou (Pap) smear is not an STI test. A Pap smear is a test that looks for early signs of cervical or anal cancer. Women with persistent HPV infections, particularly infections by HPV-16 and HPV-18, are at an increased risk of developing cervical cancer. Women and men who engage in anal sex can also develop anal cancer from HPV infections.
A normal Pap smear result says nothing about whether or not you have an STI. To check for HPV, your doctor will order a separate HPV test.
An abnormal Pap smear result doesn’t necessarily mean that you have, or will get, cervical or anal cancer. Many abnormal Pap smears resolve without treatment. If you have an abnormal Pap smear, your doctor may recommend HPV testing. If the HPV test is negative, it’s unlikely that you will develop cervical or anal cancer in the near future.
HPV tests alone aren’t very useful for predicting cancer. About 14 million Americans contract HPV each year, and most sexually active people will get at least one type of HPV at some point in their lives, warns the CDC. Most of those people never develop cervical or anal cancer.
Some STIs, such as herpes and genital warts, can be diagnosed through a combination of physical examination and other tests. Your doctor can conduct a physical exam to look for sores, bumps, and other signs of STIs. They can also take samples from any questionable areas to send to a laboratory for testing.
It’s important to let your doctor know if you’ve noticed any changes on or around your genitals. If you engage in anal sex, you should also let them know about any changes on or around your anus and rectum.
STIs are common, and testing is widely available. The tests can vary, depending on which STIs your doctor is checking for. Talk to your doctor about your sexual history and ask which tests you should get. They can help you understand the potential benefits and risks of different STI tests. They can also recommend appropriate treatment options if you test positive for any STIs.