If you are sexually active, particularly with multiple partners, there are important steps you should take to protect your health. Dr. Wilma Wooten, chief health officer for County of San Diego. California, advises that you consistently use male and female condoms, get tested for sexually transmitted disease (STD), and ask your partner(s) to do the same.
STDs are passed from one person to another during oral, vaginal and anal sex or by sharing needles. Testing is important because many people who have STDs don’t know it, Dr. Wooten said. STDs may have no symptoms or visual signs, and therefore they go undiagnosed and untreated.
However, recent additions to new public health screening programs are detecting many cases of early STDs when they are easier to treat, particularly among sexually active teens and young adults, ages 15-24.
STDs are a complex modern public health challenge, potentially infecting an estimated 19 million people each year, according to the Centers for Disease Control and Prevention (CDC).
While some STDs are symptom-free, others have very serious health consequences, especially for women, including infertility, pregnancy complications, heart, brain and kidney damage, certain types of cancer, and death.
In 2012, San Diego Public Health treated 60,545 cases of chlamydia, of which 67 percent were women, Dr. Wooten said.
The type of STD testing you need and how often you should be screened depends on your age, sexual behavior and other risk factors, she said.
Many women wrongly assume they are getting STD testing when they undergo a routine gynecologic pelvic exam, but this is unlikely if you don’t specifically request the test from your doctor.
Regardless of your age or sex, if you think you might need a test, discuss it with your health care provider and be specific about what kind of infections you think are possible. Dr. Wooten also recommends that you not rely on your sexual partner to protect your health.
"It’s important we all take responsibility for our own health," she says. "Be prepared."
What You Need to Know About Testing for Specific STDs
Here are some guidelines for specific STD tests. Always talk to a health care provider if you have any concerns regarding STDs, or if you have reason to be tested.
Chlamydia and gonorrhea
Chlamydia and gonorrhea are regularly among the leading reportable infectious diseases in the United States, according to the nonprofit American Sexual Health Organization.
You should get screened every year if:
• You’re a sexually active female under the age of 25
• You’re a sexually active female older than age 25 and at risk of STDs, for example, you’re having sex with a new partner or multiple partners
• Are a man who has sex with men
A simple urine test, or swab inside the penis in men or from the cervix in women, is collected and then analyzed in a laboratory to determine if chlamydia and/or gonorrhea are present.
Screening is important, because if you don't have signs or symptoms, you can be unaware that you have either infection. These infections can make you more susceptible to more serious STDs and can harm your baby if you should become pregnant.
Some local health departments can provide you with use-at-home test kits for these STD types.
HIV, syphilis and hepatitis
The CDC encourages human immunodeficiency virus (HIV) testing at least once, as a routine part of medical care if you're an adolescent or adult between the ages of 13 and 64. The CDC advises yearly HIV testing if you are at high risk of infection.
You should request testing for HIV, syphilis and hepatitis if you:
• Have tested positive for gonorrhea or chlamydia, which puts you at greater risk of other STDs such as HIV
• Have had more than one vaginal or anal sexual partner since your last test
• Use intravenous (IV) drugs
• Are a man who has sex with men
Your doctor tests you for syphilis by taking either a blood sample or a swab from any genital sores you may have. The sample is then examined in a laboratory. A blood sample is taken to test for HIV and hepatitis. Some facilities can provide you with the same day results.
Genital herpes
There’s no effective screening test for herpes, a viral infection that is transmitted by skin-to-skin contact. An infected person may not have any visible sores. Your doctor may take a tissue scraping or culture of blisters or early ulcers, if you have them, for a lab examination.
But keep in mind that negative test results don’t rule out herpes as a cause for genital sores. Sometimes a blood test may help detect a herpes infection, but the results aren't always conclusive.
Blood tests can help differentiate between the two main herpes virus types: Type 1 (HSV-1) most typically causes cold sores and fever blisters, although it can cause genital sores too.
Type 2 (HSV-2) is the virus that most typically causes genital sores. Determining the type of virus helps to determine the type of treatment you’ll receive, and can speed the healing of sores during an outbreak. However, there is no cure for genital herpes.
HPV
The human papillomavirus (HPV) is such a common STD that it affects nearly all sexually active people at some point in their lives. Most people never develop any symptoms and the virus typically disappears within two years without treatment.
However, certain strains of the virus are known to cause cervical cancer, throat cancer and have been associated with cancers of the vulva, vagina, penis and anus. Other strains of HPV can cause genital warts.
No HPV screening test is currently available for men. An infection can only be diagnosed by visual inspection or through biopsy of genital warts, if they exist. In women, HPV testing includes:
• Pap tests, which check for abnormal cervical cells. Pap tests are recommended every two years for women between ages 21 and 30. Women age 30 and older can wait three years between Pap tests if their past three tests have been normal. If you are older than 65 and have had three consecutive normal tests, consult your doctor about ending Pap testing.
• HPV tests collect cell samples from the cervical canal. This test can be done during routine annual exams but isn't offered to women younger than 30. That's because HPV infections are very common in the younger than 30 crowd but will ultimately clear up on their own, states womenshealth.gov, the web site of the US Dept. of Health and Human Services Office on Women’s Health.
Vaccinations that prevent the HPV types responsible for some serious cancers are available for boys and girls starting at age 9, but must be administered before they start having sex to be effective.
Locating a testing facility
If you have no idea how to find a testing facility you are not alone. There are a variety of options if you have insurance coverage, such as your primary care doctor or some privately run clinics or testing companies. Testing costs can range from below $20 to as much as $250 or more. If you don’t have insurance coverage or want to stay anonymous, there are other options.
Local government-run public health facilities and community clinics offer low cost or free STD testing and treatment based on income and are generally available throughout the United States. If you have difficulty finding a local facility, contact your state’s Health and Human Services agency.
Planned Parenthood offers affordable STD testing and treatment at more than 750 health centers around the country. To see if there’s one near you, click here.
One last word on STD testing
While most testing facilities respect your privacy or offer complete anonymity in testing, laws protecting your privacy can vary from state to state. Generally, if you are under the age of 18, you do not need parental permission to get tested. However, your state law may require a health care provider to get parental permission or to notify a parent about testing.
Lynette Summerill is an award-winning writer and Scuba enthusiast who lives in San Diego with her husband and two beach loving dogs. In addition to writing about cancer-related issues for EmpowHER, her work has been seen in publications internationally.
Sources:
Interview with Dr. Wilma Wooten, San Diego County Health Dept. 10 June 2013. Information about testing and STD prevention programs online at:
http://www.stdsandiego.org
American Sexual Health Association. Position Statement: Male Latex Condoms as a Public Health Intervention.
http://www.ashasexualhealth.org/home/position-statements.html
Sexually Transmitted Diseases. Medline Plus, National Institutes of Health.
http://www.nlm.nih.gov/medlineplus/sexuallytransmitteddiseases.html
Herpes. New York State Department of Health.
http://www.health.ny.gov/diseases/communicable/std/herpes.htm
Basic Information about HIV/AIDS. Centers for Disease Control and Prevention.
http://www.cdc.gov/hiv/topics/basic/index.htm#prevention and http://hivtest.cdc.gov/STDTesting.aspx
Pap Test Fact Sheet. Womenshealth.gov. Online at :
http://womenshealth.gov/publications/our-publications/fact-sheet/pap-test.cfm#d
Reviewed June 11, 2013
By Michele Blacksberg RN
Edited by Jody Smith