A Guide to Regular STI Screenings

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If you think you have been exposed to a sexually transmitted infection (STI), it is in your best interest to contact your healthcare provider for an STI test. In this way, you can seek treatment to either cure or manage the infection while reducing the odds of passing the STI to others.

STI testing is not a routine part of an annual checkup and often needs to be requested. This includes routine tests for certain groups—such as sexually active younger females or sexually active men who have sex with men (MSM)—who are at high risk of STIs like HIV or chlamydia.

This article provides details about the types of tests available for STI screening, including which are recommended for at-risk groups. It also helps dispel common misconceptions about STI testing so that you can make an informed choice when asking yourself, "Do I need an STI test?"

Doctor talking to her patient about her STD test
asiseeit / Getty Images

Types of STI Tests

Sexually transmitted infections, formerly known as sexually transmitted diseases (STDs), are a group of bacterial, viral, or parasitic infections that are primarily passed through sexual contact.

Common STIs include:

There is no single test that can detect all STIs. As such, you may be advised to undergo a panel of different tests based on your risk of infection.

This is due in part to the fact that certain STIs commonly occur together, such as HIV and syphilis. These are referred to as co-infections.

So, if you've come to get tested for syphilis, don't be taken aback if you are advised to undergo additional tests. This is done as a precaution, and not because the clinic assumes that you are infected.

The different STI tests may require a blood sample, a urine sample, or a genital, rectal, or oral swab.

 STI  Testing Method(s)
Chlamydia Blood, urine, swab (oral or genital)
Gonorrhea Blood, urine, swab (oral or genital)
Hepatitis A Blood
Hepatitis B Blood
Hepatitis C Blood
Herpes Blood
HIV Blood, swab (oral)
HPV Pap smear
Syphilis Blood
Trichomoniasis Blood, urine, swab (genital)

Who Needs STI Testing?

People who come for STI screening commonly do so for one of four reasons:

  • They have been notified by a public health authority that someone they've had sex with has tested positive for an STI.
  • They suspect they may have been exposed to an STI based on symptoms.
  • They recently had condomless sex and are worried that they may have been exposed to an STI.
  • They are following recommended guidelines for routine STI screening.

There are certain STIs that affect some groups more than others. Because of this, national guidelines have been established to ensure that at-risk individuals are diagnosed and treated if needed.

The Centers for Disease Control and Prevention (CDC) has issue recommendations for STD testing for all people as well as populations at greater risk of infection.

Screening Recommendations: All People

STI  Recommendation Frequency
Hepatitis C All adults 18 and over should be screened One time
HIV All people 13 to 64 should be screened as part of routine medical visit One time

Screening Recommendations: Females

STI Recommendations Frequency
Chlamydia Sexually active females under 25
Every year
Sexually active females 25 and over who are at increased risk Every year
Gonorrhea Sexually active females under 25 Every year
Sexually active females 25 and over who are at increased risk Every year
Herpes Consider for all females who seek STI screening As requested
HIV Consider for all females who seek STI screening As requested
HPV Females 21 to 29 Every 3 years
Females 30 to 65 Every 3-5 years
Trichomoniasis Consider for females at high risk As requested

Screening Recommendations: Men Who Have Sex With Men (MSM)

STI Recommendation Frequency
Chlamydia  All sexually active MSM Every year
  MSM at high risk (such as those with HIV, multiple sex partners, condomless sex, etc.) Every 3-6 months
Gonorrhea All sexually active MSM Every year
MSM at high risk Every 3-6 months
Hepatitis B MSM at high risk (especially those with HIV) As requested
Herpes Consider for MSM who have or have had an undiagnosed genital infection As requested
HIV All sexually active MSM At least once yearly
MSM at high risk More than once yearly
HPV Consider digital rectal exam to check for anal warts As requested
Anal Pap smear is available but currently not recommended due to lack of evidence regarding its usefulness in predicting anal cancer Not recommended
Syphilis All sexually active MSM Every year
MSM at high risk Every 3-6 months

Screening Recommendations: Pregnancy

 STI Recommendation  Frequency
Chlamydia All pregnant people under 25 At first prenatal visit with every pregnancy
  All pregnant people 25 and over who are at increased risk At first prenatal visit with every pregnancy
Gonorrhea All pregnant people under 25 At first prenatal visit with every pregnancy
  All pregnant people 25 and over who are at increased risk At first prenatal visit with every pregnancy
Hepatitis B All pregnant people At first prenatal visit with every pregnancy
Herpes Pregnant people who suspect they or their partner may have genital herpes As requested
HIV All pregnant people At first prenatal visit with every pregnancy
Syphilis All pregnant people At first prenatal visit with every pregnancy

Screening Recommendations: People With HIV

STI Recommendation  Frequency
Chlamydia All sexually active people with HIV When diagnosed with HIV and at least once yearly thereafter
Gonorrhea All sexually active people with HIV When diagnosed with HIV and at least once yearly thereafter
Hepatitis B All people with HIV When diagnosed with HIV
Hepatitis C All people with HIV When diagnosed with HIV
MSM with HIV When diagnosed with HIV and every year thereafter
Herpes Consider for people seeking STI testing As requested
HPV Pap test for all women with HIV When diagnosed with HIV and once yearly thereafter; after 3 consecutive normal Pap smears, retest every 3 years
Syphilis All sexually active people with HIV When diagnosed with HIV and at least once yearly thereafter
Trichomoniasis Sexually active females with HIV When diagnosed with HIV and every year thereafter

Please note that this is only a partial list of CDC recommendations. To learn which STI tests are recommended for you as an individual, speak with your healthcare provider or contact an STI clinic near you.

Barriers to Regular STI Testing

Despite the screening recommendations from the CDC and other public health authorities, the rate of testing has fallen short for many of the more common STIs.

For example, around 13% of the 1.2 million people living with HIV in the United States remain undiagnosed. Less-than-ideal testing rates for syphilis have also fueled a 413% increase in new infections between 2002 and 2017, with rates increasing year on year.

There are many reasons for this. Among them, the "shame" and stigma associated with STIs can make it difficult for some people to ask their healthcare providers for testing.

At the same time, the prospect of having to disclose a positive diagnosis to a sex partner can be overwhelming. STI testing may also force a person to reveal how they got infected, such as through extramarital sex or same-sex contact.

Moreover, with some STIs like HIV, people can become paralyzed by the fear of what the treatment will cost, what side effects may occur, and what a diagnosis means in turns of life expectancy.

Misconceptions and Moving Forward

Overcoming the multitude of concerns about STIs is not easy. On top of this, there are numerous misconceptions about STI screening that stand in the way of a person's decision to get tested.

Among them:

  • Some people incorrectly assume that their annual physical exam includes a comprehensive STI screening.
  • Others who are provided an "STI panel" incorrectly assume that it tests for includes every possible STI. Herpes is rarely included, and HPV never is.
  • Many people assume that an annual Pap smear tests for multiple STIs. Although it may include an HPV test, it does not test for other STIs.
  • Despite its name, a venereal disease research laboratory (VDRL) test only detects syphilis. It doesn't check for any other STIs.
  • An HIV test only detects HIV and does not detect other STIs. 
  • If you are treated for one STI, don't assume you're STI-free. Without additional tests, other STIs may be present.

Generally speaking, when someone says they were "tested for everything," it usually means that they don't know exactly which STIs they were tested for. Or, perhaps they were tested years ago and never thought about getting the results updated.

Whatever the reason, it is important to remember that the avoidance of testing places you at risk of complications—either now or years down the road—if you have an STI. It also places others at risk. This includes STIs that can be passed from mother to child during pregnancy or breastfeeding.

On the other hand, if you test negative and have no STI, knowing your status often reinforces safer sex practices.

By knowing the facts and seeking advice from your healthcare provider, you can better understand the benefits and risks of STI testing and make an informed choice.

Who to Call for Advice

The CDC offers a national toll-free STI hotline available 24 hours a day at 1-800-232-4636/TTY 1-888-232-6348 (English and Spanish). The hotline not only offers comprehensive advice about STIs but can also refer you to free or low-cost testing sites near you.

Summary

Testing for sexually transmitted infections (STIs) not only protects your health if you have an STI but can also protect others from getting infected.

While there are many different tests that can detect STIs like gonorrhea or HIV, there is not one that is able to detect all STIs. Even certain "STI panels" may not include otherwise common STIs like herpes or HPV.

There are certain groups who are at high risk of certain STIs and are advised to seek routine testing. These include sexually active females and men who have sex with men (MSM) who are disproportionately affected by STIs like gonorrhea and chlamydia.

Even if you test negative for STIs, knowing your status can help reinforce safer sex practices to protect yourself and others from infection.

A Word From Verywell

If you recall having had an STI test but can't remember what you were screened for, you can request of copy of your electronic medical records from your healthcare provider.

Better yet, ask your healthcare provider what STIs you should be screened for based not only on the guidelines but also on your individual risk of infection.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Elizabeth Boskey, PhD
Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases.