Awareness of sexual health and STD testing is a growing concern among sexually active adults and adolescents. That’s a good thing, considering that 20 million new sexually transmitted infections (STIs) occur every year, according to the Centers for Disease Control and Prevention (CDC).
Your primary care physician physician is likely qualified to administer STD testing, although many patients prefer to be screened by a health professional who isn't their primary care physician. Below is information on the distinction between STIs and STDs, as well as a summary of the various ways in which STDs are tested and diagnosed.
STDs vs. STIs
First of all, as you read and weigh your medical options for STD testing, you may wonder why sexually transmitted diseases are often referred to as sexually transmitted infections (STIs) and what the difference is.
Practitioners now commonly prefer the term "infection" because "disease" usually indicates that symptoms are present. The most common STIs are often asymptomatic, so clinicians feel the term infection more accurately portrays a large number of cases. The absence of symptoms in many cases shouldn't provide a false sense of security. Rather, it should alert you all the more to the need for regular STD testing.
Although the trend is moving toward using STI in literature, as you browse material on STDs, you will most likely encounter both terms used synonymously. The Guttmacher Institute states that there are more than two dozen bacterial, viral, and parasitic infections that are transmitted through sexual contact. The most common are:
- genital herpes
- genital warts
- hepatitis A, B, and C
Testing in the Doctor’s Office
Traditionally, when physicians diagnose STDs, they will firstly review your medical and sexual histories, as well as any symptoms. The following are ways your health care provider might determine whether you have an STD:
- visual inspection of genitals, mouth, and throat
- analysis of a swab taken from inside the penis, anus, cervix, mouth, or throat
- blood analysis
- urine analysis
- biopsy of tissue, often taken from a genital ulcer
Testing in a Clinic or Family Planning Center
Some patients prefer to be tested outside of their doctor’s office. Adolescents may be hesitant to discuss their sexual behaviors with a physician who is known by family members. The fact that many feel they cannot discuss sex with their doctors may be one reason that youth are affected more by STDs than any other group. According to the CDC, adolescents aged 15-25 make up 25% of the sexually active population but account for half of all new STD cases each year.
The cost of private STD testing can add up quickly. Because many patients are members of financially challenged and high-risk populations, health department clinics, family planning facilities, and STI clinics often offer income-based fee scales for their services. Many clinics even provide services at no charge to the patient.
Adults who may also have reservations about getting tested for STDs by a provider they know can receive the same testing at these clinics that they would in their doctor’s office. Clinicians have the same level of diagnostic expertise and lab analysis capabilities as regular health care providers. Many offer anonymous screening and treatment as well.
Testing At Home
The Federal Drug Administration has approved a few test kits for in-home STD screening. These tests may increase the frequency or likelihood that consumers may have for being tested. The following test kits that screen for HIV or hepatitis C may be purchased at nearly any drug store as private pay consumer products:
- OraQuick In-Home HIV Test, requires a saliva sample
- The Home Access® Express (next day) HIV-1 Test System, which requires a blood sample
- The Home Access® HIV-1 Test System, which requires a blood sample
- The Home Access® Hepatitis C, which requires a blood sample
These methods can be compared to that of testing blood sugar levels. A lancet is included in the kits and requires a simple finger stick and a dime-sized blot of blood, which is squeezed onto a collection card. Samples are either delivered to a local lab or you must arrange for same-day mail pick up.
Additionally, certain medical labs offer analysis of patient-collected urine samples or skin tissue swabs for patients who prefer alternatives to in-office exams. Patients should take incubation periods in mind when screening from home. For many STIs, positive results may not show up for as many as three months after acquiring an infection. Therefore, test results immediately following a sexual encounter with an infected partner may show up clean and provide a false sense of security, a lack of reporting, and transmission to others.
As telemedicine gains acceptance, apps like STD Triage are becoming more and more popular, especially among millennials. STD Triage allows users to consult with a licensed dermatologist, for a small one-time fee. Snap a picture of your genital rash and upload it. A physician will evaluate your listed symptoms and report back to you, often within a day or sometimes just a few hours. The doctor will let you know whether an STD might be a possibility and whether you should pursue testing or arrange to see your doctor.
Healthvana is another app that, in accordance with HIPAA privacy practices, allows you to receive your STD test results from labs that might not otherwise notify you. They’ll provide a breakdown of your results in easy-to-understand terminology that any patient can understand, another added benefit. Some apps even discreetly notify your sexual partners on your behalf—with your permission, of course.