Screening Guidelines for Sexually Transmitted Diseases

What You Need to Get Tested for and When

Midsection Of Doctor Drawing Blood Sample From Arm For Test At Hospital
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You always go to your gynecologist or other physicians for your yearly check-up. You, therefore, assume that you'd know if you were positive for an STD. The thing is... there's a good chance you're wrong. Many, if not most, private doctors do not automatically screen for sexually transmitted diseases. They may check if you specifically ask them. However, they probably won't if you haven't made the request. So, the next time you go in for your annual visit, ask your doctor if they have been, or will be, screening you for STDs. Then, if they say yes, ask what STDs they're planning on screening you for.

Even doctors who test their patients regularly, don't necessarily test for all common STDs. There are good reasons not to test for genital herpes and HPV in individuals who don't have symptoms, However, there are problems too. For one, not testing for these STDs may give some people a false sense of security. Therefore, it is important to know exactly what diseases you have and haven't been tested for. In fact, it's just as important as knowing the last time you were tested.

What should you be tested for and how often? To some extent, std screening depends on your individual risk factors. Still, some general guidelines are below:

I. There are several STDs that your doctor should test you for every year. These are also STDs it's good to be tested for before starting a new sexual relationship:

II. There are also STDs that you should be tested for regularly, but not yearly.

  • III. There are STDs for which testing is not generally recommended unless you know you have been exposed to them. You should also be tested for these STDs if you have symptoms:

    IV. Finally, there are STDs Women Should Be Tested For During Pregnancy:

    • Chlamydia: All women should be tested at the first prenatal visit. High-risk women, and women <25 years old should be tested again in the third trimester.
    • Gonorrhea: Young women and high-risk women should be tested at the first prenatal visit. High-risk women should be tested again during the third trimester. Women in areas with lots of gonorrhea should be considered high risk. 
    • HIV: Women should be tested at the first prenatal visit. They should also be tested in the third trimester. Women who were not tested during pregnancy should be rapid tested at the time of delivery. These are the CDC guidelines. However, HIV testing during pregnancy is not mandatory in all states.
    • Syphilis: Women should be tested at the first prenatal visit (all women), during the third trimester (high-risk women only), and at delivery (all women).
    • Hepatitis B: Women should be tested at the first prenatal visit. They should then be tested again in the third trimester if they are high risk
    • Hepatitis C: Women at risk should be tested at their first prenatal visit. 
    • Bacterial Vaginosis: Some studies suggest that asymptomatic women at high risk for preterm birth should be tested for the sexually associated condition bacterial vaginosis. However, the data is controversial. Testing is not supported for asymptomatic women in general.
    Sources:
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    • Cervical Cancer (current testing guidelines) – via a Pap Smear.
      Note: The majority of cervical cancers are caused by the sexually transmitted virus HPV. It's also important to know that men cannot be tested for HPV. Men can get an anal Pap smear. However, direct HPV tests are not used to detect genital infections in men. 
    • Bacterial Vaginosis
      Note: BV is considered to be a sexually associated condition rather than a sexually transmitted disease
    • Workowski KA, Bolan GA; Centers for Disease Control and Prevention. CDC Sexually Transmitted Disease Treatment Guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5;64(RR-03):1-137