10 Reasons Why Your Doctor May Not Want to Test for STDs

Many doctors, including primary care doctors, gynecologists, urologists, and dermatologists, can send tests for sexually transmitted diseases (STDs). But not all doctors are equipped to collect samples and send tests for STDs. I spend a lot of time advising people on how often they should get screened for STDs, but sometimes it's not that simple. Not all that infrequently, I hear stories from individuals who ask their doctors for an STD test and are told no.

Sometimes the doctors have good reasons for not testing for STDs. Below are some of the main reasons why doctors refuse to do STD testing. You'll also find explanations for why you might, or might not, want to get a particular test anyway.


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 waste of time, money, and resources. The problem is that people aren't populations.

There are many reasons why people might wish to be tested for STDs more often than recommended by guidelines. 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 doctor should deviate from the normal screening guidelines in your case, you should bring it up. They'll probably listen and send the test or refer you to another doctor who can. 


They Lack Access to the Right Lab

Some diagnostic tests require specialized collection equipment, a procedure, or laboratory supplies. Not all supplies are available to all physicians. If you want or need to be tested for a disease, and your doctor doesn't have the required materials, then the only solution is to go to another doctor or laboratory for testing.

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 doctors' offices.


They Do Not Know the Guidelines

Sometimes you think you should be screened for an STD, the CDC thinks you should be screened for that STD, and your doctor doesn't want to give you the test.

This may be because your doctor knows something about your individual condition or risk factors that both you and the CDC don't—for example, you might be worried about white material in your genital area that's actually a yeast infection.

It may also be that your doctor is unaware of current guidelines. For example, very few doctors actually follow the current universal HIV testing guidelines proposed by the CDC. Even in populations that are at high risk, doctors may be hesitant to test for HIV for a variety of reasons. Sometimes, they simply don't realize that they should.


If They Screen, They Must Treat

One of the reasons Pap smear guidelines have changed recently is the problem of overtreatment. The Pap screening test itself is very safe. However, follow-up biopsies and treatments 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.

Unfortunately, many doctors are afraid to screen and not treat. If watchful waiting without treatment turns out to be the wrong decision instead of the smart decision, they're likely to get sued. This is a real and understandable fear that may make it easier for them to simply screen less often in the first place.


They Do Not Understand Your Motives

Although in general most people don't get tested for STDs often enough, others go too often. Certain individuals may excessively worry about STDs every single time they have sex. Your doctor may be concerned about exacerbating this kind of fear.

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

He or she 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. It is harder to turn down someone's reasonable STD request when you know it's because they are trying to keep other people safe.


They Don't Know STD Test Protocols

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

Your doctor 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 legit. For example, many doctors are extremely concerned about the potential emotional consequences of a false positive test.

And there are, for example, good reasons rapid HIV tests are only used in high-risk populations.


They Don't See the Benefit

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

However, suppressive therapy may reduce symptoms of herpes—but a person can transmit the infection in the absence of symptoms. So there may be advantages to knowing your status even when you or your partner have no symptoms.

And HIV is an STD that is often transmitted by asymptomatic individuals.

So knowing your status is especially important if your behavior may be putting a new sexual partner at risk. There's a reason they call STDs the hidden epidemic.


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 doctors 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 doctors question if there is a real benefit to doing the test.


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—whether or not you're married—many physicians 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 doctor tends to think you are having.

Doctors 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.

My favorite gynecologist screens all of her patients every year. She sees 2-3 cases of chlamydia a month in patients most other doctors wouldn't bother to test.


It Isn't Their Area of Expertise

Who should test you for sexually transmitted diseases? Your primary care physician? Your gynecologist? Your urologist? The doctor who sees you in the emergency room when you've dropped a heavy can on your foot?

Realistically speaking, any of those doctors could test you for most STDs. There are circumstances in which any one of them might.

STD screening isn't always available in every clinic. Some blood tests can be ordered by almost any doctor. Other urine and swab tests require skills or expertise that not all doctors have. Specialized STD clinics should have doctors n 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 aged 15 to 65 years. The Centers for Disease Control and Prevention (CDC) recommends that everyone between the ages of 13 and 64 is 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.

If you're looking for STD testing because you have symptoms, your best bet is a gynecologist, urologist, or your primary care physician.

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