STD tests are often part of a normal physical for many patients, though they may be left out of the usual tests if a patient is in a low-risk category. STD tests can also be separately administered for people in high-risk groups, or for those who think they may have been exposed and want to be safe.
This guide provides information about the STD testing process. It goes over the common STDs that can be checked for, as well as the typical methods doctors use when testing for them. The goal is to provide information that helps the average reader get tested and to understand the results when they come back from the lab. This guide also touches on some of the options available for STD testing, likely costs, and frequently asked questions about the process of getting tested.
Modern STD testing in a doctor’s office is done for any one of over a dozen common diseases, or all of them at once. Single tests may be requested when it is suspected there’s a specific threat of disease, such as after exposure via a sexual partner. A specific test may also be ordered when potentially identifying symptoms are found during a routine health examination. Sometimes, a full panel of tests is performed to check for multiple STDs at once. This is most commonly done as a precaution when no specific threat is suspected. Diseases tested for may be viral, bacterial or parasitic, and include:
|HIV||This viral infection can lay dormant in the blood and other fluids of the body (such as breast milk) for long periods, gradually affecting the immune system. A blood test may reveal its presence, after which it is vital to begin treatment as soon as possible to prevent developing AIDS.|
|HPV||The virus that causes genital warts is associated with cervical cancer in women, though it may be completely asymptomatic in men.|
|Herpes||Herpes is an extremely common STD that can be caused by two different strains of the virus that causes chickenpox and shingles. There is no cure for herpes, though some treatments can manage the ulcers and inflammation caused by the disease.|
|Hepatitis C||Hep C is a serious viral inflammation of the liver that can become life-threatening if left untreated. This disease is a leading cause of liver cancer, and it often causes no symptoms for years at a time, making it nearly impossible to detect without an STD test.|
|Chlamydia and Gonorrhea||Chlamydia and gonorrhea are sexually transmitted bacterial infections that may show few or no symptoms during the early stages of infection. Though they can both cause serious problems later on, such as pelvic inflammatory disease for chlamydia, both are easily treatable with antibiotics. Both STDs are often tested for at the same time and with the same test, even if only one is suspected to be present.|
|Trichomoniasis||Trichomoniasis causes no symptoms at all for about 30% of the people who contract it, making it easy to miss this parasitic infection. Unfortunately, the inflammation the disease causes dramatically increases the likelihood of infection from other STDs you may be exposed to. Trichomoniasis can be treated with medication.|
|Syphilis||Syphilis causes sores, rashes, and several other symptoms that can easily be mistaken for other disorders. Pregnant women can pass syphilis to their babies, which may be life-threatening for them. Left untreated, the disease causes mental disturbances and can be fatal. Syphilis is entirely treatable if it is identified early enough via a blood test.|
STDs can be detected using a variety of methods, but the most common are blood and urine sampling. Women may also be tested with vaginal swabs or pelvic exams that collect a sample of cells from the cervix. There might also be a visual inspection of the genitals to identify ulcers, lesions, or other outwardly visible signs of specific diseases. Some STDs can be detected in multiple ways, though a blood or urine check is often needed to make a definitive diagnosis.
Blood testing for STDs works the way most other blood tests do. A nurse or other professional swabs an area close to a vein and inserts a needle to draw blood. The amount drawn varies depending on how many separate vials are required. In general, the more tests, the more vials, and the more blood that gets taken from a single stick. After the sample is drawn, the blood is sent to the lab for analysis.
Urine samples are less invasive, and patients can usually provide them without help from the office staff. Patients are given a sterile cup and directed to the restroom. Before the test, it is common to wipe the opening of the urethra with an antiseptic pad to eliminate any bacteria that may be present on the skin of the genitals. Ideally, the patient allows some urine to flow before collecting the sample, which flushes out the urethra and helps ensure a clean sample. The sealed sample cup is taken to the lab for testing.
The length of time it takes to get the results varies somewhat by the test. Bacterial infections generally have to be cultured on a dish before a diagnosis can be made, which may take up to several days. Viruses may be identified by the presence of certain antibodies in the blood, which tends to be a shorter process. If multiple STDs are checked for in a single round of tests, it may be the policy at the doctor’s office to deliver all the results at once, either over the phone, online, or in person during a follow-up visit. If the results are positive for any STDs, this is usually the time when a doctor discusses treatment with a patient, and medication may be prescribed.
It is not difficult to arrange STD testing at most medical offices. The CDC has expressed extreme concern about the spread of these diseases, and of the health consequences of delaying treatment, so most practitioners can either administer the tests in their offices or order them from a nearby lab. Given the high cost of treating late-stage STDs, and of the lifelong harm many of them can cause if allowed to go untreated, most insurance policies cover routine STD tests, though the less common tests may cost more to get without a medical reason for the test.
The doctor’s office isn’t the only place to get an accurate STD test. Many people opt for at-home STD tests, which can be ordered over the internet and shipped to the home in discreet packaging. The greater privacy of this approach is appealing to some people, especially to young adults who may be embarrassed to ask their doctor for an STD check. Results from at-home testing kits are generally as accurate as office or lab tests, though it may still be necessary to visit with a doctor to discuss any positive results and to go over treatment options.
Costs for at-home tests run between $38 for single-use chlamydia tests and $300 for comprehensive, multi-disease tests. Testing kits for individual STDs tend to be less expensive than the 5, 10, or 14-agent tests, though collectively, the cost of multiple tests adds up to more than the all-in-one panels. Insurance is unlikely to pay for the cost of at-home testing kits, which are generally sold like any other online items.
The accuracy of STD tests varies somewhat, but the results are generally good enough for a doctor to make a diagnosis. Some tests, such as the HIV screening, are usually given twice to confirm a positive result before treatment.
Blood collection requires a needle stick, which may be uncomfortable for some people. If the pain of a needle is especially concerning, ask the lab tech about using smaller gauges or alternate needle placement.
All medical test results are protected by law in the United States. Unauthorized disclosure of STD tests is a crime, and medical providers are required to take active measures to protect the privacy of their patients.
The CDC recommends different schedules of testing for different groups of people, based on their disease risk and the specific STD. All sexually active people between the ages of 13 and 64, for example, should get tested for HIV at least once. Sexually active gay and bisexual men, who are at elevated risk, are encouraged to get checked for HIV every three to six months. Pregnant women are encouraged to get tested for syphilis, HIV, and hepatitis B during their first trimester.
Doctors routinely consult with people who’ve gotten positive STD results about their treatment options. For some STDs, such as those caused by bacteria and parasites, a course of antibiotics can clear the infection. Anti-viral treatments may be necessary to control herpes and HIV, though neither of these are curable yet.