How often should I get tested?

I get a lot of questions from people asking me how often they should get checked for Sexually Transmitted Infections (STIs).  This is a very person dependent question, but there are some standard times you should get checked, and you may be surprised to know that when you got for your annual physical with your Primary Care Physician (PCP) it isn't standard to check for  STIs.  I know that a lot of people assume that it is done in the blood panel that your HCP draws, but unless you specifically ask for it, it isn't done. So, when should you ask for STIs to be checked?  When should we go in just to have that checked out?

What Are STIs?
STIs are really any infection that is most often transmitted through sexual intercourse and are also known as Sexually Transmitted Diseases or STDs.  They are passed from an infected person to another person through any form (oral, anal, vaginal) intercourse.  And some are even transferable with the use of condoms (yikes!)  The most frequent STIs are (in no particular order):
-Bacterial Vaginosis (BV)
-Hepatitis B, C
-Chlamydia
-Gonorrhea
-Genital/Oral Herpes (HSV 1 and HSV 2)
-HIV/AIDS
-Human Papilloma Virus (HPV)
-Pubic Lice (AKA crabs)
-Syphilis
-Trichomoniasis

How Do You Get Tested?
There are a few ways to get tested for STIs. Usually it is required to have a physical and or pelvic exam, so that your HCP can assess for warts, rashes, lesions, etc so we can view if you look to have been exposed, and also for women, we can assess your cervix and look for any changes in discharge color, or internal changes to the vaginal walls, and assess for pain with inspection due to pelvic inflammatory disease (PID) which is STI related. During your pelvic exam, a swab (just like your annual pap smear) will be sent off (to test for HPV), and for men, a swab from inside the urethra (your pee hole) may be taken to test for HPV.  You will also be required to submit urine and blood samples.  That will cover you for the all genital STIs.

How Often Should I Get Tested?
As I said earlier, it is a very personal thing, but there are some good basic rules.  I would tell you that at a MINIMUM, you should get tested for STIs annually with your annual physical starting from the time that you are sexually active (anal, oral, or vaginal), so make sure to ask your HCP to add those labs on to any others they might be ordering for you. If you have unprotected sex, get tested, and every 3 months after that for HIV until you come back negative for a full year with no other unprotected sexual encounters.  If you are in a monogamous relationship (living together, dating, married, civil union, whatever you have going on) get tested at a minimum of annually.  Call me a naysayer, but infidelity is on the rise, and to best protect yourself and ensure your safety, it is best to get tested...just for peace of mind, right? Don't assume just because you have sex with women, or because you asked your partner and they said they were clean, that you are going to be "clean" after an unprotected encounter.  Just watch out for yourself, as not all STIs are curable; they are all treatable, but some will come snack (like Herpes, genital warts)

A good rule is to assume that everyone has been exposed to an STI, and seeing as you don't want an STI, you will use all prevention possible, right?  And, think about who you are interaction with because condoms, while they decrease transmission rates, they do not prevent all transmission of STIs.  For example, herpes and genital warts are still transferable through condoms....so make sure that partner is totally worth the risk before hopping in the sack.  And, if there are any worries or concerns, talk to your HCP and be really honest and open; the HCP's at the free STI clinics have heard it all and are super laid back and cool about everything; they will assuage your fears if you don't need to be freaked out, and they will be honest with you about your risks.