When Should I Get Tested for Sexually Transmitted Infections (STIs)? Which Test Should I Take?

When Should I Get Tested for Sexually Transmitted Infections (STIs)? Which Test Should I Take?

If you are sexually active, getting tested for sexually transmitted infections is one of the most important things you can do to protect your health. Make sure you have an open and honest conversation with your doctor about your sexual history and STI testing, and ask whether you should be tested for sexually transmitted infections. If you feel uncomfortable talking to your doctor about sexually transmitted infections, there are many laboratories that provide confidential testing that is free or available at different costs.

Below is information on STD testing recommendations:

1. All adults and adolescents aged 13 to 64 should be tested for HIV at least once.
2. All sexually active women under 25 should be tested for gonorrhea and chlamydia every year. Women aged 25 and over who have risk factors, such as a new sex partner, multiple sex partners, or a sex partner who has a sexually transmitted infection, should also be tested for gonorrhea and chlamydia every year.
3. Everyone who is pregnant should be tested for syphilis, HIV, hepatitis B and hepatitis C starting early in pregnancy. Those at risk of infection should also be tested for chlamydia and gonorrhea starting early in pregnancy. Repeat testing may be needed in some cases.
4. All sexually active gay, bisexual and other men who have sex with men should be tested:

-For syphilis, chlamydia and gonorrhea at least once a year. Those with multiple or anonymous partners should be tested more often (e.g. every 3 to 6 months).

-For HIV at least once a year; they may benefit from more frequent HIV testing (e.g. every 3 to 6 months).

-For hepatitis C at least once a year if you are living with HIV.

1. Anyone who engages in sexual behaviors that may put them at risk of infection or who shares injection drug equipment should be tested for HIV at least once a year.
2. People who have had oral or anal sex should talk to healthcare professionals about throat and rectal testing options.

Genital herpes

Experts generally recommend genital herpes testing for people with symptoms or other risk factors. Most people with a herpes infection have no symptoms, but they can still pass the virus on to others. Your specialist doctor may take a tissue sample or a culture of a blister or early ulcer for testing and send it to a laboratory. However, a negative test result does not always mean you do not have herpes, especially if you have symptoms.

A blood test can also tell whether you have had a herpes infection in the past, but the results are not always reliable. Some blood tests can help your doctor see which of the two main types of herpes virus you have.

Type 1 is the virus that usually causes cold sores, although it can also cause genital sores.

Type 2 is the virus that more often causes genital sores. Still, depending on how sensitive the test is and the stage of the infection, results may not be clear. False-positive and false-negative results are possible.

HPV

Some types of human papillomavirus (HPV) can cause cervical cancer. Other HPV types can cause genital warts. Many sexually active people catch HPV at some point in their lives but never show any symptoms. In most cases, the virus clears on its own within two years.

Routine HPV testing is not recommended for men. Instead, healthcare professionals may choose to test men who have symptoms such as genital warts. A sample of the wart is taken and sent to a laboratory.

HPV testing in women includes the following:

1. Pap smear test: Pap tests, which check for abnormal cells in the cervix, are recommended every three years for women aged 25 to 65.
2. HPV test: Women aged 25 to 65 should have an HPV test alone, or an HPV test together with a Pap test, every five years if their previous test results were within the normal range. Testing may be done more often for those at high risk of cervical cancer or those with abnormal Pap or HPV test results. HPV is also linked to cancers of the vulva, vagina, penis, anus, and the mouth and throat. Vaccines can protect both men and women from some types of HPV. However, they are most effective when given between the ages of 9 and 26.

Chlamydia and gonorrhea

National guidelines recommend annual screening for the following:

1. Sexually active women under 25
2. Women over 25 at high risk of sexually transmitted infections, for example those having sex with a new partner or with multiple partners
3. Men who have sex with men
4. People with HIV
5. Trans women who have sex with men
6. People who have been forced to have sexual intercourse or engage in sexual activity against their will

Healthcare professionals test people for chlamydia and gonorrhea using a urine test or a swab. The swab is taken from inside the penis in men and from the cervix in women. The sample is then examined in a laboratory. Screening is important because you may not know you are infected if you have no symptoms.

HIV, syphilis and hepatitis B/C

Experts encourage people aged 15 to 65 to be tested for HIV at least once as a routine part of healthcare. Younger people or older adults should be tested if they are at high risk of an STI.

National guidelines recommend hepatitis C screening for all adults aged 18 to 79. Vaccines are available for hepatitis A and B and are usually given at birth. Unvaccinated adults can be vaccinated if they are at high risk of getting hepatitis A or B.

If you have any of the following risk factors, talk to your healthcare professional about HIV, syphilis or hepatitis testing:

1. Symptoms of infection
2. A positive test for another STI, which puts you at greater risk for other STIs
3. Having had more than one sexual partner since your last test (or your partner having had more than one partner)
4. Intravenous (IV) drug use
5. Men who have sex with men
6. Being pregnant or planning to become pregnant
7. Being forced to have sexual intercourse or engage in sexual activity against your will

Your specialist doctor tests you for syphilis by taking a blood sample or a swab from any genital sore you may have. The sample is examined in a laboratory. Your specialist doctor also takes a blood sample to test for HIV and hepatitis.

How long after a risky sexual contact can you be tested?

Every test has a window period; a negative result before this period has passed does not rule out infection. The HIV Ag/Ab test is reliable after 18-45 days.

The incubation period ranges for some of the most common sexually transmitted infections are shown in the table:

Benefits of Early Diagnosis and Treatment

If you think you may have a sexually transmitted infection, it is important to stop engaging in sexual activity and get treated.

Early diagnosis and treatment of sexually transmitted infections play an important role in stopping the spread of these infections among you, your sexual partners and their sexual partners. In some cases, it may even save your life.

Some of the potential risks of untreated sexually transmitted infections are:

1. Pelvic inflammatory disease and infertility from untreated chlamydia and gonorrhea in women
2. Cervical cancer from untreated HPV in women
3. Pregnancy and birth-related risks from untreated bacterial sexually transmitted infections, HIV and hepatitis B
4. Organ damage, dementia, stroke or death from untreated syphilis

It is important to take care of your sexual health. Not everyone will voluntarily disclose their STI status to you. By asking questions, screening new sexual partners, and having open and honest discussions about sexually transmitted infections, you can take control of your sexual health. Or, even if you have no complaints, you can have our sexual health check-up panel done.