How STDs Are Diagnosed

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Sexually transmitted diseases, or STDs, are infections that spread through intimate contact with body fluids, such as semen, saliva, blood, and vaginal secretions. 

Common STDs include herpes, chlamydia, gonorrhea, HIV, and HPV. These infections cause a diverse variety of symptoms or may present with no symptoms at all

If you think you may have been exposed to an STD it is important to go to a doctor and get tested. Treating an STD in the early stages can prevent transmission of the infection and prevent serious complications, such as infertility and pelvic inflammatory disease.

Self-Checks

Only a doctor can diagnose an STD. If you have symptoms of an STD or have engaged in risky sexual behavior, such as unprotected vaginal, anal, or oral sex, speak to your doctor about getting tested.

STD screening is not an automatic part of a routine physical or annual gynecologic exam as standard healthcare. Be proactive about your sexual health and ask your doctor to test you for STDs.

Many STD symptoms are non-specific and may be caused by a number of STDs or another type of illness entirely. In addition, most people with STDs have no symptoms, which means they look, smell, and feel exactly the same as they would without having an STD.

Labs and Tests 

Your doctor will take a detailed history about your risk factors and perform a physical examination before taking lab tests, which may include a urine sample, cheek swab, blood work, or fluid samples such as discharge from sores. Your doctor may also take cell cultures from the penis, vagina, urethra, cervix, anus, or throat.

There is no standard STD screening panel so you will need to ask for specific tests. Don't assume that you've been tested for something unless your doctor explicitly states it.

How to Ask for an STD Test

Asking for STD testing can feel awkward, but it is an important part of your sexual health and you will need to be direct. Since there is no such thing as a standard comprehensive STD screening, you will need to be more specific with your doctor. Here are a few ways to state your request:

  • "Although I always practice safer sex, I like to be screened on a yearly basis for my own peace of mind. Therefore, I would like to be tested for chlamydia, gonorrhea, syphilis, herpes, HIV, and trichomoniasis."
  • "I'm about to start having sex with a new partner and we'd both like to be tested before we do. Could you test me for the bacterial STDs, HIV, and herpes?"
  • "I recently had unprotected sex and I'm worried that my partner may have exposed me to something. Could you give me a full battery of STD tests including chlamydia, gonorrhea, syphilis, HIV, herpes, and hepatitis? I know it might take some of those tests a bit of time to turn positive, but it would make me feel better to do something."

For comprehensive STD screening, there are a number of tests that you can ask for. These include:

Bacterial & Fungal STDs

  • Gonorrhea and chlamydia are the easiest STDs to test for. Young women are sometimes screened for them automatically. Anyone with a new partner or multiple partners should probably be screened for these STDs, which are tested for with either a swab or a urine test. With a urine test, you'll probably get results back in a few business days. Swab tests, which are done with culture techniques, may take up to a week.
  • Syphilis testing is typically performed with a blood test and is recommended for pregnant women and certain high-risk groups such as prison inmates, men who have high-risk sex with men, and patients with another STD. In the absence of symptoms, however, other people are not usually tested for syphilis due to a risk of false positives. If you are tested using a VDRL test (blood test), you should get your results in under a week. There is also a rapid test, which can provide results in less than 15 minutes, but is not available at all doctor's offices. 
  • Trichomoniasis and bacterialvaginosis are usually tested for using a vaginal swab and the results may be available while you're still in the office. For trichomoniasis testing, another option is to send a swab or urine sample to a lab and the results could come back in a day to a week. There is also a rapid trichomonas test that takes as little as 10 minutes. Note: men are unlikely to be screened for trichomoniasis unless their partner is positive, but they can be tested using urine. 

Viral STDs

  • HIV tests are almost always blood tests. but some clinics can test a swab of your oral fluid. Everyone should be tested, at least once, for HIV. People who engage in risky behavior should be tested more often. Rapid HIV tests, which are only available in certain settings, can give results in as little as 30 minutes. More often, a blood or saliva sample will be sent out, and you'll get your results in under a week. 
  • Herpes screening is done with a blood test unless you have symptoms. If you have symptoms, you may be diagnosed by a physical exam or a swab of your sores. Some doctors are reluctant to use herpes blood tests in the absence of symptoms due to concerns about the risk of false positive tests, particularly when combined with herpes stigma. Results usually come back in 1-3 days.  
  • Hepatitis is diagnosed with a series of blood tests. You can also be vaccinated for hepatitis A and B. These vaccinations are widely recommended. Testing results usually take a day or more, depending on where the sample needs to be sent. There is a rapid test that gives results in 20 minutes, but it must be confirmed with an additional blood test. 
  • HPV is easier to detect in women than men. There is no standard test for HPV in men unless they have anal sex. However, women may be tested for HPV alongside their pap smear. Some dentists will also offer an oral swab test to look for throat infections with HPV. Unfortunately, these oral tests are not easy to find. Where tests are available, the turnaround time is usually a couple of days. 

Any blood test that tests for antibodies can take up to six months to turn positive. In addition, they will generally not be positive for at least several weeks after you're infected. Antibody tests include the standard screening tests for herpes and HIV. Therefore, if you are being screened after a risky encounter, it is important to let your doctor know. There may be other testing options to detect very new infections.

You should always ask what screening tests your doctor has performed. Don’t hesitate to ask for additional tests if you think they are appropriate.

Other Concerns

STD testing is often, but not always, covered by insurance. If your insurance does not cover it, testing is usually available for free at a clinic.

Most doctors are willing to screen you for STDs if you ask, but some doctors may decide not to test you. If this happens, you can find another doctor or visit a Planned Parenthood or STD clinic

STD test results are covered by HIPPA, the Health Insurance Privacy and Portability Act. That means that access to your results is limited to you, your healthcare provider, and anyone you choose to share them with.

However many STDs are nationally notifiable diseases. That means that your results for those diseases must also be reported to the state health department. Furthermore, in some states, the health department is required to notify your sexual partners or needle-sharing partners of positive test results. 

If you are concerned about privacy, anonymous STD testing is available through many online test companies as well as certain STD clinics.

A Word From Verywell

If you are open and upfront about your reasons for wanting to test, most doctors will respect you and your desire to take care of your health. However, if you get any other reaction from your doctor, it is okay to look elsewhere for medical care. Your sexual decisions are your own. It is not your doctor's place to judge you for them. Their job is to take care of your health and help you to do the same.

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Article Sources

  1. St lawrence JS, Montaño DE, Kasprzyk D, Phillips WR, Armstrong K, Leichliter JS. STD screening, testing, case reporting, and clinical and partner notification practices: a national survey of US physicians. Am J Public Health. 2002;92(11):1784-8. doi:10.2105/ajph.92.11.1784

  2. Seña AC, Miller WC, Hobbs MM, et al. Trichomonas vaginalis infection in male sexual partners: implications for diagnosis, treatment, and prevention. Clin Infect Dis. 2007;44(1):13-22. doi:10.1086/511144

  3. World Health Organization. Hepatitis B. Updated January 24, 2018.

  4. Centers for Disease Control and Prevention. State Statutes Explicitly Related to Sexually Transmitted Diseases in the United States, 2013. Published June 5, 2014

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