Knowing your status doesn’t have to be scary. Find out which test you need, how often you need it, and if it actually involves peeing in a cup.
Reason #482 to get tested: Most infections come with no symptoms at all. So unless your genitals are psychic, you need regular screenings whenever you’re at risk. And just because an STI isn’t causing symptoms, that doesn’t mean it’s harmless. Untreated chlamydia and gonorrhea in cisgender women or trans men can lead to chronic pelvic pain, ectopic pregnancy, and even infertility.
2. HALF of all new STIs happen to people under the age of 25.
That’s huge considering this group makes up just a quarter of the sexually active population, according to a 2013 report from the CDC.
STIs can be spread through oral, anal, and vaginal sex — and sometimes just through skin-to-skin genital contact (which is the case with HPV and herpes) or sharing sex toys. So if you’re engaging in any activities that can result in transmission — even if you think your partner is STI-free — it’s time to talk to your doctor about which tests you should be getting.
4. If you’ve been exposed to an STI, it might take a little while for it to show up on a test.
Different STIs can take a matter of days or weeks to show up on a test, Dr. Peter Leone, medical director at the North Carolina HIV/STD Prevention and Control Branch, tells BuzzFeed Life. So keep that in mind when you’re getting tested (and when you’re scheduling an appointment). Plus, it can take up to 3 months to detect HIV depending on which test you get (more on that later).
Minors are allowed to consent for their own health services for STIs, anywhere in the U.S., according to the CDC. That said, they cannot stop your private insurance company from sending an explanation of benefits or a medical bill to your parents if they are the primary insurance holders (and those forms typically list the tests you had). Still, talk to your doctor if you think you may be at risk for an STI and they should be able to help you make the best decision.
6. Your insurance should cover some or all of the costs for STI testing. But if they don’t, there are always cheap or free options out there.
Any screening recommendation from the U.S. Preventative Services Task Force that’s graded A or B must be covered by insurance (if you’re in the U.S.). These recommendations are pretty consistent with the ones from the CDC, which we’ll go over in detail here.
Your insurance might only cover annual screenings for certain STIs. But if you have symptoms or you’re at a higher risk, that would be considered an STI “test” rather than a “screening,” and if it’s coded correctly, your insurance should still cover it, says Leone. You can also find free or cheap testing at local health departments, health clinics, or Planned Parenthood, he says. You can also go to GetTested.cdc.gov to find affordable testing centers in your area.
7. Ideally, you want to get tested in between partners.
This way you’re able to approach a new partner with a clean slate. And if you do have an infection, you’re able to pinpoint when you got it and find out how to not pass it along to your next partner. If you have multiple partners or you’re switching partners more frequently than you can be tested, make sure to practice safer sex practices by using a barrier method every single time. And don’t assume that if you slipped up once with someone, the damage is already done and it’s not worth using a condom the next time.
These recommendations for cisgender men and women (which means they identify with the gender they were assigned at birth), come from the 2010 CDC STD Treatment Guidelines. Keep in mind that your lifestyle, community, and unique sexual behaviors may mean that you should be screened more or less frequently. We’ll go into more detail about all that in a bit.
8. If you’re a woman under 25 and you have sex with men or women, you should get a chlamydia test and gonorrhea test every year.
Yes, that’s even if you haven’t switched partners. Why? Because the vast majority of chlamydia infections occur in women under 25 and it’s often completely symptomless, so it’s best to just cover your bases, says Leone. Also, most men aren’t getting screened for chlamydia, so if you have a male partner (even if you’re sure you’re both monogamous), it’s still wise to be tested every year. And remember that sex isn’t just penis-in-vagina. This also includes oral sex, anal sex, the sharing of sex toys, etc.
9. If you’re a woman 25 or older AND you have either a new partner or multiple partners (of either gender), you should also get a chlamydia test and gonorrhea test every year.
So if you’ve hooked up with anyone new since your last test, this is your cue to get retested.
10. If you’re a man who has sex with men (MSM), you should be tested for chlamydia, gonorrhea, and syphilis at least once a year. If you have multiple partners or anonymous partners, you should be screened more often (at 3-month or 6-month intervals).
This includes testing for gonorrhea and chlamydia in the urethra for anyone who has insertive intercourse and in the rectum for anyone who has receptive anal intercourse, as well as testing for gonorrhea in the pharynx (in your mouth where your nose connects to your throat) for anyone who has receptive oral intercourse.
If you have multiple sex partners, or if your partner has multiple sex partners, it is recommended that you screen for these STIs more frequently. This might mean at 3-6 month intervals, so check with a doctor or health clinic to get a specific recommendation.
This is a blood test that will determine if you’re infected. In addition to screening, adults should receive hepatitis A and hepatitis B vaccines if they haven’t already. Hepatitis C screening is also recommended in HIV-positive MSM.
12. There are technically no STI screening guidelines for men who only have sex with women (aside from HIV screening) — but that doesn’t necessarily mean you should never get tested.
You should be tested any time one of your sexual partners has been diagnosed with an STI, Dr. Vanessa Cullins, vice president for external medical affairs at Planned Parenthood Federation of America (PPFA), tells BuzzFeed Life. For instance, if your partner has trichomoniasis (a common STI caused by a parasite that’s often asymptomatic in men), you’ll want to get tested ASAP to make sure you don’t reinfect her. Remember, just because you don’t have symptoms, that doesn’t mean the infection is harmless.
In some states, physicians are allowed to give a prescription or medication to a patient to give to their partner if they’ve been diagnosed with chlamydia or gonorrhea — even without examining the partner. This is called expedited partner therapy and you can find out what’s allowed in your state by checking out this map from the CDC.
13. There are also no specific guidelines for women who only have sex with women (WSW).
While there are no recommendations for more frequent STI screenings for WSW (as there are for MSM), there is also no evidence to suggest that WSW should screen less frequently (per the 2014 CDC STD Treatment Guidelines, which are still under consideration). So if a doctor says you don’t need to be screened for something based on your sexual orientation — even though you have certain risk factors or symptoms — don’t be afraid to speak up or find another provider.
14. EVERYONE should get an HIV test at least once.
The CDC recommends that everyone between the ages of 13 and 64 be tested at least once in their life. We’ll talk more about the different kinds of HIV tests in a little bit. For more information, check out the CDC guide to HIV testing.
15. But that doesn’t necessarily mean you ONLY need one HIV test in your whole lifetime.
If you change partners or have unprotected sex, you should probably be tested annually, suggests Leone. You should also be tested more frequently if you’re in a high-risk group, which could include any of the following: You’ve had sex with someone who might be HIV-positive, you’ve had sex with someone and you don’t know their HIV status, you have multiple partners, you’ve had sex with someone who might have multiple partners, you’re a man who has sex with men, you have a history of drug injection, you’re a commercial sex worker, you live in a community where HIV is particularly prevalent, etc.
There are no hard and fast recommendations for how often most of these groups should be tested for HIV, so it’s important to talk about your risk with a doctor and determine the best screening guidelines for you. For the most part, you should be tested (or at least ask your doctor about your risk) annually unless you’re in a mutually monogamous relationship and you’ve both been tested.
16. If you’re a man who has sex with men, you should get an HIV test every year. If you have multiple partners or anonymous partners, you should be screened more often (at 3-6 month intervals).
You’re “at risk” for gonorrhea if you are under 25, if you’re over 25 but have new or multiple partners, if you live in a community where gonorrhea is common, if you’ve had gonorrhea before, if you’ve had other STIs, if you don’t use condoms consistently, if you’re a commercial sex worker, or if you use drugs. You’re “at risk” for hepatitis C if you have a history of drug-injection use or a history of blood transfusion or organ transplant before 1992.
Here’s what you need to know about testing for STIs if you’re a transgender man or woman, or if your partner is a transgender man or woman.
Transgender individuals have a gender that is different from what they were assigned at birth. Because gender identity is different than sexual orientation, it’s important to note that trans men and trans women may have sex with any gender. It’s also important to remember that some trans people have had gender confirmation surgery while others have not. All of these factors can influence which STI tests you should be getting and how frequently you should be getting them.
However, it’s possible to assess your risk by considering your genital anatomy, your partner’s genital anatomy, your sexual behaviors, and other outside risk factors. “It should come down to organs and risk,” Dr. Madeline Deutsch, clinical director at the Center of Excellence for Transgender Health. “Providers should be talking about who you are having sex with, what’s going where, and what are the circumstances that surround that sexual behavior.”
For instance, a trans man with a vagina should get regular Pap tests and STI screenings consistent with the guidelines for cisgender women who have sex with men or women. “A vagina should be screened regardless of who it’s attached to,” says Deutsch. And if you’re having receptive anal sex or have multiple partners with a penis, follow MSM guidelines, regardless of your own gender or sexual identity, or your partners’.
After gender confirmation surgery, the recommendations may be even more personalized. If you have had vaginoplasty, for instance, you may be at a reduced risk for certain infections since there’s no vaginal mucosa and it doesn’t open to the abdominal cavity, explains Deutsch. However, if you have had phalloplasty, it’s not yet known if you would be at an increased or decreased risk of any particular infections, so talk to a doctor about your personal risk factors.
19. Because STI screening for trans people will be based on your unique sexual behaviors and anatomy, it’s important to assess your risk with a healthcare provider to determine which tests you need.
It can be incredibly difficult and intimidating to disclose your gender identity, sexual orientation, and specific sexual behaviors to a doctor, which is why it’s crucial to find a provider who is well versed in this. You can search for LGBT-friendly providers at GLMA.org, WPATH.org, or trans-health.com. These are databases where providers have specifically submitted their offices as being LGBT-friendly or specializing in LGBT care. (Editor’s note: Have other resources you trust? Please post them in comments.)
Approximately 1 in 6 adults in the U.S. have genital herpes, and most people don’t know they have it, according to the CDC. Still, routine screening for herpes isn’t recommended (based on cost-effectiveness and the likelihood for false positives in low-risk populations). If you have any symptoms (lesions on or around the mouth, genitals, or rectum that break and leave painful ulcers, which may take weeks to heal), if you’ve been with someone who was diagnosed with herpes, or if you’ve had unsafe sex or sex with multiple partners, ask your doctor if you can be tested.
21. Before you even think about HPV testing, consider getting the HPV vaccine.
HPV (or human papillomavirus) is the most common STI out there, and almost all sexually active people get it at some point in their lives, according to the CDC. Most HPV infections clear on their own, but a few high-risk strains can lead to genital warts or even cancer. The surest defense against HPV is getting vaccinated at an early age. The CDC Advisory Committee on Immunization Practices recommends routine vaccination of all females and males at ages 11 or 12 (but they can get them as early as age 9). They also recommend that women catch up on the vaccine by age 26 and men catch up by age 21 if they haven’t already gotten all three shots. However, men can also be vaccinated up to age 26.
Even if you’ve missed the boat, some experts still suggest getting the vaccine as an adult if you’re at risk. So talk to a doctor about it if you think you would benefit. Just remember that insurance won’t cover the cost after a certain age.
22. If you have a vagina, you should get an HPV test at age 30. But you may get one earlier if you have an abnormal Pap test.
Starting at age 21, all women should be getting a Pap test every 3 years, which looks for cervical cell changes that could point to cancer, per the American College of Obstetricians and Gynecologists. If you’re a trans man with a vagina, you should be following these guidelines, too. If you’re a trans woman and you’ve had bottom surgery, talk to your doctor for specific screening guidelines based on your anatomy.
If your doctor notices anything abnormal in your Pap test, they may call for additional testing — like an HPV test or colposcopy (where they closely examine your uterus and often collect a sample for testing). Otherwise, you wouldn’t have an HPV test until the age of 30, when it’s recommended that you get a Pap test and HPV test together. From ages 30-65, it’s recommended that you get these two tests together every 5 years OR just a Pap test alone every 3 years. However, if you ever have any abnormal Pap test or HPV test, you’ll need to be screened more frequently (at least for a period of time).
Obviously, get vaccinated if you haven’t already. But what should you do if you think you’ve been exposed? Your doctor can do a visual exam for genital warts caused by HPV, since most people actually miss these on their own, says Leone. He also suggests a digital rectal exam and sometimes a rectal pap for men over 30 who may be at risk for HPV. These can check for infections, lesions, or masses in the anal canal, and they would be especially beneficial for those who have receptive anal intercourse.
24. And if you’re ever experiencing ANY strange symptoms, head to your doctor or a health clinic immediately to get tested.
If you notice any itching, burning, unusual discharge, redness, rash, lesions/sores, uncomfortable urination, unusual odor, pain in the penis/testicles/vagina/vulva/pelvic region/lower abdomen, or anything else that seems really off, get it checked out. There are some STIs that you might only get tested for if you have certain symptoms (like trichomoniasis, bacterial vaginosis, and sometimes syphilis), so don’t assume that you’ll just deal with it at your next annual check-up.
The doctor might take a cell sample from the cervix, penis, vagina, or anus or test any discharge (per Planned Parenthood). If you’ve had oral sex or anal sex, they may also collect swabs from your throat or rectum.
26. Syphilis testing is typically done with a blood test.
The doctor might also test the fluid from a sore (per Planned Parenthood).
30. There are a few different ways to test for herpes.
If you currently have symptoms or lesions, your doctor can take a swab of the area, which is called a direct test. If a swab test is negative, your doctor may take a blood test to confirm. Most providers recommend type-specific serologic tests, whichare blood tests that can detect the antibodies for either herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2).
31. There are few different ways to test for HIV.
The most common HIV test is the antibody screening test (also called immunoassay), which detects the antibodies your body makes against HIV (per the CDC). This can be either a blood test or an oral swab. Either of those can be run as either a lab test or a rapid test, which gives results in 30 minutes or less. But keep in mind: Lab-based blood tests typically pick up the virus before the oral tests and the rapid tests do. If the test is negative and you may have been exposed in the past 3 months, you should get another test after 3 months, since it’s possible that your immune system hasn’t made the antibodies yet or that the test wasn’t able to pick them up yet.
A newer type of HIV test looks for both antibodies and the antigen (which is part of the virus itself). This one is a blood test and it may be able to detect the virus as soon as 3 weeks after exposure.
There are also at-home HIV tests, like the Home Access HIV-1 Test System (which tests a finger-prick sample that you send to a lab) and the OraQuick In-Home HIV Test (which is an oral swab that gives rapid results).
Regardless of which test you use, any positive result would need to be confirmed by a follow-up lab test. There are several different kinds of these as well, and you can find out more about them here.
32. Talking about STI testing with your partner is normal and necessary.
Even though it seems like it, this is not an exhaustive list of everything there is to know about STIs and testing. There are so many unique cases and exceptions to the rules, which is why this should be an ongoing conversation — not a pamphlet to glance at every once in a while. Talk with your partner about what you’re doing now, what you’ve done in the past, and what you’ve been tested for recently. Then have this conversation with your doctor to make sure you’re getting the right tests at the right frequency.