How Often Should You *Really* Get Tested for STDs?
If you request them at your annual checkup, that's great—but it still might not be enough.
Heads up, ladies: Whether you're single and ~mingling~, in a serious relationship with bae, or married with kids, STDs should be on your sexual health radar. Why? STD rates in the U.S. are higher than ever before, and chlamydia and gonorrhea are well on their way to becoming antibiotic-resistant superbugs. (And, yes, that's as scary as it sounds.)
Despite the tidal wave of bad STD news, far too few women are actually getting screened for sexually transmitted diseases. A recent survey by Quest Diagnostics found that 27 percent of young women don't feel comfortable talking about sex or STD testing with their doctor, and another 27 percent report lying or avoiding discussions about their sexual activity, as we shared in "The Infuriating Reason Young Women Aren't Getting Tested for STDs." That's partially because there's still a stigma around STDs-like the notion that if you contract one, you're dirty, unhygienic, or should feel ashamed about your sexual behavior.
But the reality is-and this will blow your mind-people are having sex (!!!). It's a healthy and freaking awesome part of life. (Just look at all the legit health benefits of having sex.) And any sexual contact at all puts you at risk of STDs. They do not discriminate between "good" or "bad" people, and you can pick one up whether you've slept with two or 100 people.
Even though you shouldn't feel ashamed of your sexual activity or STD status, you do need to take responsibility for it. Part of being a sexually active adult is caring for your sexual health-and that includes practicing safe sex and getting the appropriate STD tests-for your sake and the sake of everyone you're getting with.
So how often do you actually need to get tested? The answer might surprise you.
How Often You Need to Get Tested for STDs
For women, the answer depends largely on your age and your sexual behavior risk, says Marra Francis, M.D., a board-certified ob-gyn and executive medical director at EverlyWell, an at-home lab testing company. (Disclaimer: If you're pregnant, you have a different set of recommendations. Since you should be seeing an ob-gyn anyway, they'll be able to guide you through the appropriate tests.)
- Anyone who has unprotected sex or shares injection drug equipment should be tested for HIV at least once a year.
- Sexually active women under age 25 should receive annual screenings for chlamydia and gonorrhea.Gonorrhea and chlamydia rates are so high in this age group that it's recommended you get tested whether you're being "risky" or not.
- Sexually active women over age 25 should receive annual screenings for chlamydia and gonorrhea if they engage in "risky sexual behavior" (see below). Gonorrhea and chlamydia rates drop after age 25, but if you're engaging in "risky" sexual behavior, you should still get tested.
- Adult women don't need routine syphilis tests unless they have unprotected sex with a man who has sex with other men, says Dr. Francis. This is because men who have sex with men are the main population most likely to contract and spread syphilis, says Dr. Francis. Women who do not have contact with a man that fits these criteria are at such a low risk that testing isn't necessary.
- Women ages 21 to 65 should be screened with cytology (a Pap smear) every three years, but HPV testing should only be done for women age 30+. Note: The guidelines for HPV screenings change often, and your doc might recommend something different based on your sexual risk or previous test results, says Dr. Francis. However, HPV is so commonly diagnosed in young adults-who have a greater chance of fighting off the virus and therefore a minimal risk of developing cervical cancer from it-that it's resulting in a lot of unnecessary colposcopies, which is why the general guidelines do not require HPV screening before you turn 30. These are the current guidelines from the CDC.)
- Women born between 1945 and 1965 should be tested for hepatitis C, says Dr. Francis.
"Risky sexual behavior" includes any of the following: Engaging in sexual contact with a new partner without condom use, multiple partners in a short time period without condom use, having sex with individuals who use recreational drugs that require hypodermic needles, having sex with anyone engaged in prostitution, and having anal sex (because there's much more damage done as far as breaking skin and transmission of bodily fluids), says Dr. Francis. Even though "risky sexual behavior" sounds shame-y, it probably applies to most people: Take note that having sex with even just one new person without a condom puts you in the category, so test yourself accordingly.
If you're single, there's one major rule you need to know: You should get tested after every new unprotected sex partner. "I recommend that if you have unprotected sex and are worried about exposure to an STI, that you get tested within a week of the exposure but again in six weeks and then at six months," says Pari Ghodsi, M.D., a board-certified ob-gyn in Los Angeles and a fellow of the American College of Obstetricians and Gynecologists.
Why do you have to get tested so many times? "Your immune system takes time to develop antibodies," says Dr. Francis. "Especially with blood-borne sexually transmitted diseases (like syphilis, hepatitis B, hepatitis C, and HIV). Those can take several weeks to come back positive." However, other STDs (like chlamydia and gonorrhea) can actually present symptoms and be tested for within a few days of infection, she says. Ideally, you should get tested both before and after a new partner, with enough time to know that you're STD-negative so that you don't pass STDs back and forth, she says.
And if you're in a monogamous relationship, you need to keep in mind: There are different recommendations for people in monogamous relationships and in monogamous relationships with a risk of infidelity. Check your ego at the door; if you think there's even a chance your partner may be unfaithful, you're better off getting tested in the name of your health. "Unfortunately, if there is ever a concern for a partner going outside of the relationship for any sexual contact, then you should actually follow the routine screening for people at risk," says Dr. Francis.
How to Get Tested for STDs
First, it pays to know how doctors test for each type of STD:
- Gonorrhea and chlamydia are checked using a cervical swab.
- HIV, hepatitis, and syphilis are checked with a blood test.
- HPV is often tested for during a Pap smear. (If your pap smear shows abnormal results, your doctor may recommend you get a colposcopy, which is when your doctor checks your cervix for HPV or cancerous cells. You can also get an HPV screening separate from a regular pap smear, or Pap and HPV cotesting, which is like both tests in one.)
- Herpes is tested with a culture of a genital sore (and is usually only tested when you have symptoms). "Your blood can also be checked to see if you have ever had exposure to the herpes virus, but again this does not tell you if exposure was oral or genital, and oral herpes is very common," says Dr. Ghodsi. (See: Everything You Need to Know About Oral STDs)
See your doc: Your insurance may only cover annual screenings, or they may cover "interval screenings" more frequently depending on your risk factors, says Dr. Francis. But it's all dependent on your plan, so check with your insurance provider.
Visit a clinic: If hitting up your ob-gyn isn't an option every time you need to get tested (there is a nationwide ob-gyn shortage, after all), you can use sites such as the CDC or LabFinder.com to find an STD testing location near you.
Do it at home: Don't have the time (or gumption) to go to a clinic IRL? Luckily, STD testing is becoming easier than ever, thanks to the straight-to-consumer models that started with products like bras and tampons and has now reached sexual health care. You can order an STD test to do right in your home from services like EverlyWell, myLAB Box, and Private iDNA for around $80 to $400, depending on which one you use and how many STDs you test for.