Navigating STI Testing Part I: The Facts About Full Panel STI Testing

April is STI Awareness Month, and one essential aspect of STI prevention is testing. Testing for STIs is vital not only for individuals in open or casual relationships, but also for those in long-term, monogamous relationships. However, the process of getting tested can be daunting and confusing. In this article, we will discuss what happens when you get tested for STIs.

When you ask for a “Full Panel” of STI tests, it’s important to be specific about which tests you want because there is no consistent answer to what constitutes a full panel. Most commonly, a full panel includes tests for HIV, Syphilis, Chlamydia, Gonorrhea, and sometimes Hepatitis. For individuals assigned female at birth, the panel may also include testing for Trichomonas, a lesser-known STI. However, a full panel typically does not include testing for Herpes or HPV, the virus that causes genital warts.

Testing for HIV typically involves a blood draw, which is sent to a lab for analysis. Results can take one to two days, and the test can detect HIV as little as 10 days up to about 30 days after exposure. Rapid HIV testing is also available, but it’s not typically performed at doctor’s offices unless you’re accessing PrEP or PEP. You’re more likely to encounter rapid tests at health fairs, Pride events, bars, and bathhouses. You can even purchase rapid HIV tests at pharmacies and perform them at home. The CDC provides a database of organizations across the United States that offer free HIV self-tests through the mail at https://www.cdc.gov/hiv/basics/hiv-testing/hiv-self-tests.html

Testing for Syphilis also involves a blood draw, and there are different types of tests available. It’s important to inform your doctor if you’ve ever had Syphilis in the past, even if you’ve been treated and cured. Some tests will always return a positive result if you’ve had it in the past, so your provider will want to run a different test.

Testing for Chlamydia and Gonorrhea typically involves a urine sample. While the infamous “white light” test is no longer necessary, it’s important to know that a urine test will only detect Chlamydia and Gonorrhea if you have them genitally. If you’re having oral or anal sex, it’s possible to get Chlamydia and Gonorrhea in those places as well. We recommend testing all body parts used for sex. To test for Chlamydia and Gonorrhea in the throat and rectum, a swab is taken, and many doctors will let you perform the rectal swab yourself. It’s easy and painless, and doing it yourself helps minimize the embarrassment many patients can experience from this process.

Hepatitis testing involves a blood draw, and there are three different types of Hepatitis: A, B, and C. Whether and which types of Hepatitis your provider tests for may vary based on their standard procedures, what you request, and what your risk factors are. We’ll discuss Hepatitis more next month.

Trichomonas Vaginalis is a parasite that commonly causes urinary pain in people assigned female at birth. Unfortunately, those assigned male at birth are rarely tested for it, and most insurance does not cover the testing. This is problematic because a study of partners of infected women found that 72% of partners tested positive for Trichomonas, highlighting the importance of testing for all genders. Individuals assigned male at birth can be tested through a urine sample, semen sample, or a urethral swab. Trichomonas is the most common nonviral sexually transmitted infection, being even more prevalent than Gonorrhea and Chlamydia in some studies. However, it remains incredibly under-diagnosed and treated, particularly among those assigned male at birth.

Moving on to Herpes and HPV, these infections are not typically included in STI testing panels. This may seem surprising, given the stigma around these two infections. However, there are several reasons why HIV and HPV are not routinely tested for. For one, they are more difficult to test for outside of an active outbreak, and blood testing can often produce false positives. Additionally, both infections are widespread, with 67% of the world’s population currently infected with HSV-1 and 13% with HSV-2. Many more will likely acquire HSV by the end of their lives. Given the high prevalence of these infections and the difficulties in accurately testing for them, the benefits of testing may not outweigh the unnecessary stigma around them. Further, given the ubiquity of the viruses and the fact that most people who have them are asymptomatic, testing will provide little benefit in terms of prevention.

This covers the various options for STI testing. Stay tuned for the next installment, where we will discuss how often you should be tested and where you can go for testing. If you have any questions, please feel free to email us at questions@fearlessex.com. We will also be adding Q&A posts soon, so let us know what you want to know!

References

CDC Fact Sheet on Herpes – https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm

WHO Fact Sheet on Herpes Simplex Virus – https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus

Hobbs, M. M., Lapple, D. M., Lawing, L. F., Schwebke, J. R., Cohen, M. S., Swygard, H., Atashili, J., Leone, P. A., Miller, W. C., & Seña, A. C. (2006). Methods for detection of Trichomonas vaginalis in the male partners of infected women: Implications for control of trichomoniasis. Journal of Clinical Microbiology, 44(11), 3994-3999. doi: 10.1128/JCM.00952-06