TeenHealthFX - Answers - How Do You Test For STDs?

Sexually Transmitted Diseases / Question
Published: June 26, 2007

Dear TeenHealthFX,

Hello TeenHealthFX. This is quite an emergency really. I’m fourteen and my boyfriends 17. We have been together 9 months and we are quite sexually active. Although I am a virgin, he has slept with up to forty girls, only one unprotected from STD's/STI's, but has had oral sex (both giving and receiving) unprotected on many occasions. We have had oral sex unprotected but I did go to the doctors with him before we did anything sexual at all, because he wanted an STD check to prove to me he was clean. The doctor suggested a blood test, a urine test and a swab from the back of the mouth to check for all STI's. A few weeks later we went back for the results, and the doctor gave us the paper. The sheet said my boyfriend was clear of all STD's. Recently, I've heard that the three procedures he had done would not test him for everything. Should I be worried? PLEASE reply. I’m so scared.

Signed: How Do You Test For STDs?

Dear How Do You Test For STDs?,

Since you mention both STDs and STIs in your letter, TeenHealthFX would like to take the opportunity to inform our readers about the difference between these two terms. Both STDs (Sexually Transmitted Diseases) and STIs (Sexually Transmitted Infections) can be passed from person to person during various types of sexual contact. The difference between the two terms is that STDs are infections occurring with symptoms, and STIs are infections that do not necessarily have any noticeable symptoms. Some prefer the term STIs when discussing this topic to stress the many types of infections that can be passed from one sexual partner to another regardless of whether or not there are any types of symptoms present at the time sexual contact takes place.

With the prevalence of STIs, especially among teens and young adults, it is critical to be well-informed about them and about testing options. It sounds like you are on your way in terms of being well-educated about this topic since you insisted that your boyfriend be tested prior to being sexually active with him. In terms of your concern that your boyfriend may not have been tested for all STIs, it is important to know that STI tests may test for a single disease or consist of a number of individual tests for any of a wide range of STIs – but there is not one test for all STIs. Therefore, if you want to be tested for STIs, you need to discuss with your healthcare provider what tests are most appropriate for you. FX would also like to stress to our readers that, in general, do not assume that just because blood was drawn or a urine sample was taken that you were automatically tested for STIs. You have to make sure various STIs are being tested for by making specific requests of your healthcare provider or testing facility.

Here are some details on available tests:

Blood tests: For hepatitis A, B, And C; herpes (although most blood tests cannot distinguish between type 1 and type 2), syphilis, and HIV.
Urine test: Chlamydia, gonorrhea, and HIV.
Swab cell culture or discharge sample from the throat, anus, cervix, or urethral opening of the penis: Bacterial vaginosis, Chlamydia, gonorrhea, and trichomoniasis.
Swab DNA test from the cervix or urethral opening of the penis: Chlamydia, gonorrhea, and HPV. The HPV DNA test is used for women to follow up on an abnormal Pap smear that indicates HPV infection. It is not reliable for testing HPV in men.
Swab sample from a sore or lesion: Herpes and syphilis.
Swab sample from oral fluids: HIV.
Visual Exam: This can detect crabs, herpes, and HPV.

When to consider testing and what to test for:

The CDC recommends that ALL sexually active young people under the age of 25 be screened annually for Chlamydia, even if symptoms are not present.
Women over 25 should be screened for Chlamydia if they are at risk for Chlamydia infection, such as having a new sexual partner or if they have had multiple sex partners.
Some STIs, such as Chlamydia, gonorrhea, herpes and HIV, have infection rates that are highest among teens and young adults (and that often do not have symptoms). So if you are getting tested, these are important STIs to consider getting tested for.
Young women should have an annual pelvic exam and Pap smear, which is a cervical swab test that can detect abnormal cell changes possibly caused by HPV.
If you are thinking about becoming sexually active with a new partner, you and your partner should BOTH be tested together. (Even if you are already sexually active with someone, it is not too late to get tested)
If you think you might experiencing any symptoms related to STIs, refrain from any sexual activity and get tested right away.
If you have used IV drugs, or have had unprotected sexual contact with an IV drug user, talk to a healthcare provider about being tested.
If you are pregnant, the CDC recommends getting an HIV test as early as possible in the pregnancy as antiretroviral HIV treatment during pregnancy can significantly lower the chances that an HIV infected woman will pass the virus on to her baby. Screening for syphilis, hepatitis B, and Chlamydia are also recommended for pregnant women, as well as women at risk of gonorrhea, hepatitis C, and bacterial vaginosis.

If you are concerned about the tests your boyfriend had, suggest to him that he contact his doctor to find out what STIs were already tested for, and to discuss whether there are other STIs that he should consider being additionally tested for. If you are concerned about yourself, you can also receive your own STI tests.

FX wants to stress to our readers that not all STDs appear right away – that in some instances a disease can be carried without any outward symptoms, leaving a greater risk of passing that disease onto others. And because it is generally much easier to prevent the transmission of STDs than it is to treat them, FX encourages people to make safer sex decisions. This can include using a condom during vaginal, anal or oral sex. You can also learn more about safer sex practices by reading our answer to “Condoms And STDs”, as well as by talking to your primary care physician or any other medical professional.

If you need information about whether or not you should consider being tested, or what kinds of STIs you should be tested for, you can contact FFYR (Fight For Your Rights) hotline at 1-888-BE-SAFE-1. For more information on STI testing, go to the American Social Health Association’s Facts and Answers about STDs. You can also contact the CDC hotlines for STDs (800-227-8922) and HIV/AIDS (800-342-AIDS).

If you don't have a doctor and live in northern New Jersey, you can call the Adolescent/Young Adult Center for Health at 973-971-6475 for an appointment or contact your local teen health center or Planned Parenthood. You can also contact Girl’s Street – A Young Woman’s Health Program – at 908.522.2555.

Signed: TeenHealthFX