According to the Office on Women’s Health, more than 19 million new sexually transmitted diseases (STDs) occur each year in the United States. Half of all sexually active individuals will contract an STD in their lifetime, says the American Sexual Health Association. Left untreated, they can cause severe health problems including:
- organ damage
Unfortunately, many people do not receive prompt treatment for STDs. In part, this is because STDs are highly stigmatized. It’s also because many STDs have no symptoms or very nonspecific symptoms. When people do not know they are infected, they do not seek treatment. The only way to know if you have an STD is to get tested. Fortunately, diagnostic testing is readily available.
STD testing is a good idea for anyone who is, or has been, sexually active. It’s an especially good idea to get tested if:
- you are about to begin a new relationship
- you and your partner are thinking about not using condoms
- your partner has cheated on you
- you have multiple partners
- you have symptoms that suggest you might have an STD
If you are in a long-term, mutually monogamous relationship, and both of you were tested before entering the relationship, you may not need regular STD testing. However, many people in such long-term relationships were not tested before getting together. It’s possible that one or both of you may have an STD that has been undiagnosed for years.
There are a number of different STDs. It can be confusing to know which ones you should be tested for. It is a good idea to discuss your sexual history honestly with your doctor. Common STDs that you might want to be tested for include:
- HIV (human immunodeficiency virus)
- hepatitis B
Doctors will not usually offer to test you for herpes unless you have a known exposure or ask for the test.
Asking for Testing
Don’t assume that you are automatically being tested for all STDs at your annual physical. Many physicians do not regularly test their patients for STDs. You need to ask your doctor for STD testing. You should also ask which tests are being done and why.
Taking care of your sexual health is nothing to be shy about. If you are concerned about a particular infection, ask. The more honest you are, the better treatment you can receive. The doctor cannot help you without knowing the whole story.
You may receive testing for STDs at your regular physician’s office or at a free testing clinic. Where you go is a matter of personal preference. Several STDs are notifiable diseases. That means your doctor is legally required to report positive results to the government. This is done because the government uses disease tracking to improve public health. Notifiable STDs include:
At-home tests and Internet tests are also available for some STDs. However, these tests are not always reliable. Make certain the FDA has approved any test you buy. Alternatively, look for options that send you for testing at a reputable lab.
It’s important to share your sexual risk factors with your doctor. In particular, you should always tell your doctor if you engage in anal sex. Not all anal STDs can be detected using standard tests. Your doctor might recommend an anal Pap smear to screen for rectal cancer.
You should also be sure to tell your doctor about:
- types of protection used during vaginal, oral, and anal sex
- medications being taken
- known or suspected exposures to STDs
- whether you or your partner have other sexual partners
Many people are worried that STD tests could be embarrassing or uncomfortable. Fortunately, most STDs can be tested for using urine or blood samples. STDs that can be detected through urine or blood tests include:
In some cases, urine and blood tests are not as accurate as other forms of testing. It may also take a month or longer after infection for certain blood tests to be reliable.
Some STDs, such as herpes and genital warts, are usually diagnosed through a combination of physical examination and other tests. A physical exam can look for sores, bumps, and other signs of STD infection. Your doctor can then take samples from any questionable areas to assist with diagnosis.
It’s important to let your doctor know if you have noticed any changes on or around your genitals.
Many doctors also use vaginal, cervical, or urethral swabs to check for STDs. Vaginal swabs can be taken during a pelvic exam. Urethral swabs are taken by inserting a cotton applicator into the tip of the penis. If you have anal sex, a rectal swab may be taken as well. This can be used to test for the presence of infectious organisms in your rectum.
In some cases, doctors will let patients take the swab themselves. Do not let embarrassment stop you from getting an STD test. Talk to your doctor about whether there are testing options that will work for you.
Strictly speaking, a Papanicolaou (Pap) smear is not an STD test. A Pap smear is a test that looks for early signs of cervical cancer. A negative Pap smear says nothing about whether or not you are infected with STDs.
However, women with persistent human papillomavirus (HPV) infection (particularly HPV-16 and HPV-18) are at an increased risk of developing cervical cancer. Therefore, sometimes a Pap smear is combined with an HPV test.
An abnormal Pap smear does not mean that you have, or will get, cervical cancer. Many abnormal Pap smears resolve without treatment. An abnormal Pap smear also does not mean you have HPV. That requires a separate test.
If you have an abnormal Pap, your doctor may recommend HPV testing. If the HPV test is negative, it’s unlikely that you will develop cervical cancer in the near future. However, HPV tests alone are not very useful in predicting cervical cancer. Close to 14 million Americans are diagnosed with HPV each year, and most sexually active people will have at least one type of HPV at some point, says the Centers for Disease Control and Prevention (CDC). There is no commercial test for HPV in men.
Sexually transmitted infections are common, and testing is widely available. Tests can vary, depending on which STD is being tested, so talk with your doctor about which tests you want and what you are at risk for.