Are there routine STI tests that I should be doing?

Dear Frustrated, 

With all the contradictory information out there on Sexually Transmitted Infections (STIs) and Sexually Transmitted Diseases (STDs), your frustration is understandable. While terms are often used interchangeably, some health care professionals may use STI to refer to the bacteria, virus, parasite, or fungus contracted and use STD to describe the development of the infection into a condition with symptoms. Because of this, STI will be used for consistency throughout this response.  

STI tests, which come in many forms, help identify infections early on and help you gain access to treatment if necessary. STIs can be both symptomatic and asymptomatic, meaning a person can be infected and not be showing any signs or symptoms. Because of this, the frequency of your recommended routine tests depends on your risk factors—such as having unprotected sex or your age. In addition to these tests, more frequent and immediate testing is recommended for those who are experiencing symptoms, those with a sexual partner who has symptoms or a positive test result, or those with a partner with no recent test results. Continue reading to learn more about STI testing, risk factors, and where to find clinics that offer testing.  

What are STI tests and are there different types? 

STI tests—or screenings—are used to test for the presence of sexually transmitted infections. That said, these screenings can identify STIs even without the presence of symptoms. STI testing comes in various forms, including: 

• Oral swab: Saliva is collected from your mouth or throat with a swab and may be used to test for chlamydia, gonorrhea, and oral herpes.
• Genital or rectal swab: Cells from your genital or rectal area, genital discharge, or fluid from blisters or sores are collected with a swab. This swab can be used to test for chlamydia, gonorrhea, herpes, and human papillomavirus (HPV).
• Blood test: A small sample of blood is collected from a finger prick or a vein using a small needle. This test can be used to identify syphilis, hepatitis B, human immunodeficiency virus (HIV), and (sometimes) herpes.  
• Urine test: You will be provided with a sterile cup to urinate into. This urine sample can be tested for chlamydia, trichomoniasis, and (sometimes) gonorrhea.
• Physical assessment: A health care provider will examine your body for sores, blisters, or rashes. The presence of these symptoms may indicate the contraction of syphilis; herpes; hepatitis A, B, and C; HIV; HPV; gonorrhea; or chlamydia.
• Lumbar puncture or spinal tap: Following the administration of an anesthetic, a hollow needle is inserted into your lower spine to collect cerebrospinal fluid. This test is usually used if a health care provider suspects you have late-stage syphilis or if the brain or spinal cord is affected by herpes. 

List adapted from Cleveland Clinic and MedlinePlus 

While a physical assessment and lumbar puncture must be performed by a health care provider, at-home test options for swabs, blood, and urine may be available. These at-home tests typically include instructions for sample collection and provide any necessary tools. The samples are sent to a lab for testing and results are usually received within a week. 

When should you get tested? 

The guidelines for who, what, and when of STI testing often take into consideration risk factors and your sex assigned at birth. This is because those assigned female at birth (AFAB) have been found to have unique STI-related risks. Guidelines vary by type of STI, so consider reviewing the different screening recommendations if you’re interested in testing for a particular STI. 

Depending on your health history and sexual activities, a health care provider may recommend that you get tested more often than what’s typically suggested for routine STI testing. Discussing any concerns about your recommended routine testing with a health care provider may help them learn more about your specific needs and timelines when it comes to STI testing. This is also important because getting tested is the only way to know with 100 percent certainty if you have an STI.  

Why should you get tested? 

There are many reasons why you might want to get tested for STIs. You may be experiencing symptoms, have found out you were exposed, or have a new partner and want to make sure you know your status before having sex for the first time. You may also have it as a part of your routine testing during an annual exam. Regardless of the reasoning, getting a screening may give you peace of mind or an opportunity to access treatment as early as possible, if necessary. Early treatment may help prevent the spread of the infection and the development of further symptoms. It may be important to note that STIs may result in long-term adverse health effects if left untreated so testing early and often can also help to reduce that likelihood. 

Where can you get tested? 

Testing may be accessible through various kinds of clinics, including a health care provider’s office or health center at universities or colleges. For more information about where you can get tested, it may be useful to visit the Centers for Disease Control and Prevention (CDC) or check out your school’s health center webpage. 

Getting tested for STIs is an important way to help keep yourself, and your sexual partners, safe. In addition to getting tested, there are many safer sex practices that you could engage in to lower your chances of contracting or spreading an infection. 

Hoping that your confusion has been cleared!