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STI tests: What do you need to know and why?

You have annual physical exams and screenings and never receive a diagnosis for a sexually transmitted infection. You don’t have any symptoms, so you must be in the clear. Right?

Not necessarily. Some STIs don’t cause symptoms, and patients often have to request STI tests or STI screening. Have a conversation with your health care provider if you’re sexually active. If you feel comfortable you should discuss your sexual history. They can recommend appropriate tests based on your risk level.

According to Centers for Disease Control and Prevention, a sexually transmitted infection is a virus, bacteria, fungus or parasite people can get through sexual contact. “Sexual contact” can have different meanings for patients. So, your provider may ask you to clarify to help determine appropriate tests. A sexually transmitted disease develops because of an STI, and the term implies the infection has led to some symptom of disease.

Dr. Sinduja Lakkunarajah, a Marshfield Clinic Health System adolescent medicine specialist, explains STI tests recommendations depending on sex, age and risk factors. Some STIs are more uncommon and only tested for if you have symptoms.

Different recommendations for young men and women

The Centers for Disease Control and Prevention updated its screening guidelines in 2021. Women under the the age of 25 and men who have sex with men should have yearly testing for chlamydia and gonorrhea. You may need screening more often depending on your risk level. “When your doctor asks about your sexual history, partners and practices, they are doing so to gauge your risk and evaluate need for testing, or additional tests,” Dr. Lakkunarajah said.

Why is screening important? Common STIs like chlamydia and gonorrhea can lead to infertility in women if undiagnosed and untreated, and sometimes can lead to pelvic inflammatory disease. People who do not have symptoms can inadvertently pass the infection to their partners.

People living in a high-risk areas or engaging in high-risk behaviors should get STI tests. For example, bigger cities are associated with a higher risk of getting a STI.

Download Playing it Safe with STIs Handout

infographic showing who and how someone should be tested for STIs such as chlamydia, gonorrhea, syphlis, HIV, HPV, hepatis C, hepatitis B, herpes simplex and more

STI tests during pregnancy protects parent and baby

Pregnant people undergo testing for several STIs regardless of risk since STIs can lead to health problems in a developing fetus.

You can treat infections during pregnancy or preventive measures can reduce the risk of passing the infection to the baby.

More testing recommended for people at risk

Other infections, including Hepatitis B and C, syphilis and HIV can be transmitted sexually. They also can be transmitted when infected blood enters the body of an uninfected person. People who received donated organs or had blood transfusions before 1987, use injection drugs or had a needle stick injury are encouraged to talk to their health care provider about testing regardless of their sexual history. Get a STI screening after unprotected sex with a new partner

“Patients are always encouraged to talk to their partners about STI testing or STI status before having sex so that they can help minimize passing of potential infection,” Dr. Lakkunarajah said. “However, sometimes it can be hard to have that conversation. So if you become sexually active and condoms are not always used, you should get testing done about four weeks after.”

There are some infections that must be reported. If you test positive for these infections, some public health departments will contact partners. Otherwise, you should tell current and past partners about their exposure to potential STIs.

“Given that STI testing is a very personal test, you should also remember to share your contact information with your doctor. Then they can call you directly with results,” Dr. Lakkunarajah said.

For questions about STIs, talk to a Marshfield Clinic Health System provider.

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