10 Reasons Why Your Healthcare Provider May Not Want to Test for STDs

If your healthcare provider isn't recommending testing for sexually transmitted diseases (STDs) there could be a variety of reasons—both reasonable and concerning—as to why.

Their decision may be related to clinical guidelines or concerns about invasive follow-up tests that prove unnecessary. They might simply not have supplies or lab access to easily run STD tests, or they may be swayed by professional beliefs or personal perceptions.

It's helpful to have a sense of what may shape a decision not to test for STDs so you can have conversation with your healthcare provider about whether or not you feel the move is right for you.

Here are 10 such reasons, plus information of why you might (or might not) want to get a particular STD test.

1

They Only Follow Screening Guidelines

A woman about to take a urine sample

Tero Vesalainen/Getty Images

Screening guidelines exist for a reason. Their goal is to target the highest risk populations and maximize testing efficiency while minimizing a waste of time, money, and resources. The problem is that this doesn't account for individual case considerations.

There are many reasons why people might wish to be tested for STDs more often than guidelines recommend. There are also reasons why people might be tested at an age when the guidelines don't recommend testing at all.

Such reasons might include:

  • Finding out that a past partner was unfaithful
  • History of unprotected sex
  • Multiple sexual partners
  • Starting a new sexual relationship

If you have any reason why your healthcare provider should deviate from the normal screening guidelines in your case, bring it up. If you're still met with a "no" or you can't get a referral, consider getting a second opinion.

2

They Lack Access to the Right Lab

Some diagnostic tests require specialized collection equipment, tools, or laboratory supplies. Not all healthcare providers have these at their disposal.

If you want or need to be tested for a disease, and your healthcare provider doesn't have the required materials, then the only solution is to seek a healthcare provider or lab that does. Your healthcare provider may even have a provider or lab that they refer patients to regularly.

This will mainly be an issue for certain urine tests, bacterial cultures, and smears (i.e., for bacterial vaginosis or trichomoniasis) rather than blood tests. However, some blood tests do require special collection tubes or types of preparation that may not be available in all healthcare providers' offices.

3

They Do Not Know the Guidelines

It may also be that your healthcare provider is unaware of current guidelines. For example, very few healthcare providers actually follow the current universal HIV testing guidelines proposed by the Centers for Disease Control and Prevention (CDC).

Even in populations that are at high risk, healthcare providers may be hesitant to test for HIV for a variety of reasons. Sometimes, they simply don't realize that they should.

4

If They Screen, They Must Treat

One of the reasons Pap smear guidelines have changed is the problem of overtreatment. The Pap screening test itself is very safe. However, follow-up biopsies and treatments that can follow an abnormal result can cause unnecessary damage to a woman's cervix and long-term reproductive health.

Studies have shown that, if left untreated, many lesions will eventually spontaneously resolve on their own. Testing, then, may reveal an infection that really could just be left alone.

Unfortunately, many healthcare providers are afraid to screen and not treat. If watchful waiting without treatment turns out to be the wrong decision, there may be legal consequences. This is a real and understandable fear that may make it easier for them to simply screen less often in the first place.

5

They Do Not Understand Your Motives

In general, most people don't get tested for STDs often enough. However, others go too often. Certain individuals may excessively worry about STDs every single time they have sex. Your healthcare provider may be concerned about exacerbating this kind of fear by agreeing to frequent testing.

If you are seeking screening either because you have a known exposure or are considering starting a new relationship and want to know where you stand, explain your logic to your healthcare provider.

They may be more willing to screen you in the absence of symptoms if they understand that you have a good reason to want to know your STD status.

6

They Don't Know STD Test Protocols

The diagnostic tests that are available change over time. As such, healthcare providers may not be aware of every new test as it comes about (e.g., urine testing for chlamydia and gonorrhea).

Your healthcare provider may also know that a test exists, but doubt whether it is smart to use on you. If that is the case, discuss their concerns. They may be legitimate.

For example, many healthcare providers are extremely concerned about the potential emotional consequences of a false positive test result. This is particularly true when it comes to rapid HIV tests, which are only used in high-risk populations.

7

They Don't See the Benefit

Some healthcare providers may underestimate your risk of having an STD or contracting an infection from someone who doesn't have symptoms. They may be hesitant to screen people for asymptomatic diseases, particularly those without serious long-term health risks.

However, herpes and HIV are examples of STDs that can be transmitted in the absence of symptoms, even if suppressive therapies are being used.

Knowing your status is especially important if your behavior may be putting a new sexual partner at risk. Advocate for yourself if you feel testing is indeed necessary, even if it's just for your peace of mind.

Also remember that there may be cases where you think you should be screened for an STD, but your healthcare provider doesn't want to give you the test because they know something about your individual condition or risk factors that you don't.

For example, you might want a test because you are worried about white vaginal discharge, but your healthcare provider notes that the consistency is characteristic of a yeast infection, not an STD.

8

They Worry About Potential Stigma

One of the biggest issues surrounding testing for highly socially stigmatized diseases such as genital herpes and genital warts is that some healthcare providers believe that the emotional trauma of a diagnosis causes more harm than the potential for spreading a disease asymptomatically.

It's true that finding out you have herpes or genital warts can be a life-changing experience. It can induce major depression, affect social and romantic relationships, and overall have a highly negative impact on someone's life—even if they never have symptoms.

Combined with the fact that you may live your whole life never knowing you are infected with one of these diseases, some healthcare providers question if there is a real benefit to doing the test.

9

They Do Not See You as "at Risk"

It's easy to get tested for STDs if you're young and unmarried. But if you're older, many healthcare providers may not be as worried about you as they should be.

In part, this is because young people are actually at greater risk of STDs. It's also because the older you get, the less sex your healthcare provider tends to think you are having.

Healthcare providers are more likely to suggest STD screening, or agree to screen you if they think of you as "at risk." It's a false choice, though, because even many people who seem to be at low risk are far from risk-free.

10

It Isn't Their Area of Expertise

Who should test you for sexually transmitted diseases? Your primary care physician? Your gynecologist? Your urologist? Dermatologist?

Realistically speaking, any of those healthcare providers could test you for most STDs. But STD screening isn't always available in every clinic.

Some blood tests can be ordered by almost any healthcare provider. Other urine and swab tests require skills or expertise that not all healthcare providers have.

Specialized STD clinics should have healthcare providers on site who are trained in performing tests (like collecting a sample from a sore) and should have all of the equipment needed to test for STDs.

The United States Preventative Services Task Force (USPSTF) recommends that clinicians screen for HIV infection in adolescents and adults ages 15 to 65 years. The CDC recommends that everyone between the ages 13 and 64 be tested for HIV at least once as part of routine health care. For those at higher risk, the CDC recommends getting tested at least once a year.

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