A Guide to Regular STD Screenings
“I got tested for everything” is never what you want to hear when you’re talking about STD testing. In general, when someone says that, it means that they don’t know what STDs they have been tested for. They may assume that their annual exam included STD testing when it didn’t. They may also assume that their doctor’s “STD panel” included every disease they cared about.
The truth is, many people probably are not getting the STD screening tests recommended by the CDC for sexually-active people in their risk categories. People often assume that if blood tests were drawn, or a Pap smear was done at a yearly check-up, that they are covered. Unfortunately, most doctors don’t do STD testing routinely part of a yearly check-up. In fact, many patients find that they have to ask their doctors for STD tests. Furthermore, they have to ask for specific tests, or they won’t know what they were and were not tested for.
What STD Tests Do You Need?
There is no single STD test that can test for all STDs—let alone give you a full and accurate picture of your sexual health. Sexually active individuals should be regularly screened for at least chlamydia, gonorrhea, and cervical cancer. The CDC also recommends universal HIV testing. Depending on your individual risk factors, there might also be other STD screening recommendations that apply to you. However, there are also certain STDs that most doctors do not regularly screen for—including herpes and HPV.
When screening doesn’t occur, people may not realize they have an STD for years. That can make it very easy for asymptomatic diseases to spread out of control. If doctors were more proactive about routine screening, the “hidden epidemic” might be better in hand.
Barriers to Regular STD Testing
The shame and stigma associated with STDs make it difficult for many people to ask their doctors for testing. This may be particularly true for older patients and patients who have long-standing relationships with their physicians. Many doctors are just as uncomfortable talking about safe sex and STDs as their patients, and this discomfort can make it difficult for them to discuss the tests that need to be performed.
Another problem is that many doctors, particularly those in private practice, may not think that their patient population is at risk of acquiring an STD. However, there is no sexually active population at such low risk for chlamydia and other STDs that regular screening would not be a benefit.
There are some places that are relatively good about conforming to STD screening guidelines, such as Planned Parenthood, and it may be easier for some people to go there than to ask their regular physician for tests. Still, there’s no reason not to make STD testing part of your annual exam. The tests may well be covered by your insurance, and making them part of your annual visit will ensure that they get done on a proper schedule.
Common Misconceptions About STD Screening
Don’t feel silly if you believe some of the incorrect assumptions about specific STD tests. Here are the facts about different kinds of testing for STDs:
- Many women assume that the ap smear they get during their annual exam is also an STD test. It’s not (although it may include an HPV test). Many gynecologists do not routinely screen their patients for STDs. That’s particularly true for patients who are over the age of 24. This means that many women remain unaware of a symptomatic STD infections for years. That’s something that can have serious consequences, such as an increased risk of infertility.
- A VDRL test is only a test for syphilis. It doesn’t test for any other STDs, particularly not viral STDs. The VDRL test won’t detect HIV, HPV, herpes, or hepatitis B. It stands for venereal disease research laboratory rather than referring to a virus. In fact, syphilis is caused by a bacteria, not a virus.
- An HIV test only looks for HIV. Doctors will not always follow up even a positive HIV test result with routine STD screening.
- If a doctor tells you that you have gonorrhea or chlamydia, don’t assume you’ll be STD free after a course of antibiotics. Some doctors and clinics routinely screen young people for these two, extremely common, bacterial STDs, but do not test them for anything else. Unfortunately, when patients hear they have gonorrhea or chlamydia and that it can be treated, they often assume that it also means they are free and clear of any other STDs. That isn’t necessarily the case and, without additional tests, other STDs can remain undetected.
Take Charge of Your Sexual Health
People expect that their doctors will know how to test them appropriately and do so without them asking. But not all doctors know or follow the guidelines. The best thing you can do is approach your doctor with a list of specific diseases you would like to be screened for. Alternatively, say that you wish to be comprehensively tested and ask what that means to your doctor. Then, if the doctor’s definition of “comprehensive” doesn’t include a disease you are concerned about (such as herpes), that test can be added.
If you have been tested for STDs and received a positive or negative result from your doctor, it’s important for you to ask exactly what you were tested for. It may turn out you were only screened for HIV or chlamydia. In short, if you want to know whether you are free of STDs, you should ask for the tests you want. If you think you have been tested, but don’t know what you’ve been tested for, there’s a good chance that you weren’t tested at all.
If you are sexually active, you need to protect your health by overcoming any discomfort and asking about regular STD screening. Learn which tests are recommended for your age, gender, and lifestyle. You can check your medical paperwork or electronic medical record to see what you have and have not been tested for. Then it might be time to either ask your doctor for the tests you need or to explain test results.
- 2015 Sexually Transmitted Diseases Treatment Guidelines: Screening Recommendations and Considerations Referenced in Treatment Guidelines and Original Sources. CDC.
- Chlamydia Screening Among Sexually Active Young Female Enrollees of Health Plans—United States, 2000–2007. MMWR Weekly April 17, 2009 / 58(14);362-365
- Goyal MK, Witt R, Hayes KL, Zaoutis TE, Gerber JS. Clinician Adherence to Recommendations for Screening of Adolescents for Sexual Activity and Sexually Transmitted Infection/Human Immunodeficiency Virus. The Journal of Pediatrics. 2014;165(2):343-347. doi:10.1016/j.jpeds.2014.04.009.