Here are some guidelines for STD testing for specific sexually transmitted diseases.
Gonorrhea and chlamydia
Get screened annually if:
- You're a sexually active girl or woman under age 25
- You're a woman older than 25 and at risk of STDs — for example, if you're having sex with a new partner or multiple partners
- You're a man who has sex with men
If untreated, gonorrhea and chlamydia in women can cause PID, a condition that can lead to infertility. These infections can also significantly increase your risk of acquiring other STDs such as HIV.
Gonorrhea and chlamydia screening is done either through a urine test or through a swab inside the penis in men or from the inside of the cervix in women. The sample is then analyzed in a laboratory. Screening is important, because if you don't have signs or symptoms, you can be unaware that you have either infection.
HIV, syphilis and hepatitis
Request HIV, syphilis and hepatitis testing if you:
- Test positive for gonorrhea or chlamydia, which puts you at greater risk of other STDs
- Have had more than one sexual partner since your last test
- Use intravenous (IV) drugs
- Are a man who has sex with men
- Are concerned you've been exposed
Your doctor tests you for syphilis by taking either a blood sample or a swab from any genital sores you might have. The sample is examined in a laboratory. A blood sample is taken to test for HIV and hepatitis A and B.
It's possible that you may test negative for HIV, syphilis or hepatitis if you've recently acquired the infection. Tests for these infections work by detecting antibodies your immune system produces in response to specific viruses and similar agents. Because the immune response to some infections remains undetectable for several weeks, you may need to be rescreened at a later date.
Getting vaccinated for hepatitis A and B can prevent these infections.
Genital herpes
No good screening test exists for herpes, a viral infection that can be transmitted even when a person doesn't have symptoms.
Your doctor may take a tissue scraping or culture of blisters or early ulcers, if you have them, for examination in a laboratory. But a negative test doesn't rule out herpes as a cause for genital ulcerations.
A blood test also may help detect a herpes infection, but results aren't always conclusive. You may ask for a "type-specific" IgG blood test, which differentiates between the two types of the herpes virus, measuring antibodies to the viruses in your blood. Type 1 is the virus that more typically causes cold sores, although it can also cause genital sores. Type 2 is the virus that more typically causes genital sores. Still, the results may not be totally clear, depending on the sensitivity of the test and the stage of the infection. False-positive and false-negative results are possible.
HPV
Being infected with certain types of human papillomavirus (HPV) is the most important risk factor for developing cervical cancer.
No HPV screening test is available for men, in whom the infection is diagnosed only by visual inspection or biopsy of genital warts that don't appear in every case. In women, HPV testing involves:
- Pap test, once a year if you're younger than age 30 or every three years if you're age 30 or older and have had normal test results your past three tests
- DNA test of the HPV virus, in combination with a Pap test, if you're over age 30
The HPV test is collected with a brushing from the cervical canal. Women with both a negative Pap test and a negative HPV DNA test are at low risk of developing significant precancerous changes of the cervix over the next three years.
The combination of Pap test and HPV DNA testing is not approved by the Food and Drug Administration (FDA) for women younger than 30 because HPV infections that will ultimately clear up on their own are more common in this age group, and a positive test result may lead to unnecessary additional testing and treatment.
The HPV DNA test can test for both low-risk types of HPV, which may cause genital warts, and high-risk types that may cause cervical cancer. Your doctor may recommend testing only for the high-risk types because of their threat to your health. Since no treatments exist for HPV itself — although treatments do exist for genital wart outbreaks caused by HPV — paying for a test to find the low-risk types may be of little use to you.
Girls and women ages 9 to 26 can help prevent HPV infection by receiving the HPV vaccine.
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