What a test does and does not cover
No single test checks for everything, and "a full panel" means different things at different clinics. A routine screen usually covers chlamydia and gonorrhea by urine sample or swab, and HIV and syphilis by blood draw. Herpes is generally not tested without symptoms, and no approved test exists for HPV in the throat or in men. Chlamydia and gonorrhea infect the site of contact, so a urine test will miss an infection in the throat or rectum. Tell the clinician plainly what kinds of sex you have, and ask for swabs of those sites.
How often
CDC guidance sets the floor, and more partners means more frequent testing.
- Everyone aged 13 to 64 should be tested for HIV at least once.
- Every adult should be tested once for hepatitis C and once for hepatitis B.
- Sexually active women under 25, and older women with new or multiple partners, should be tested for chlamydia and gonorrhea every year.
- Men who have sex with men should be tested at least yearly for HIV, syphilis, chlamydia and gonorrhea, and every three to six months with multiple partners.
Timing matters
A test taken too soon after exposure can miss an infection. Chlamydia and gonorrhea usually show within one to two weeks. A laboratory HIV test on blood from a vein detects most infections 18 to 45 days after exposure, and a rapid fingerstick test can take up to 90 days. Syphilis can take several weeks to appear. After a possible HIV exposure, go to an emergency room or clinic immediately and ask about post-exposure medication, which must be started within 72 hours.
If a test is positive
Chlamydia, gonorrhea and syphilis are cured with antibiotics. HIV and herpes are managed with medication, and a person whose HIV is suppressed to undetectable levels does not transmit it through sex. Recent partners need to be told and treated, and the local health department can notify them without naming you. Avoid sex until seven days after treatment is complete, and retest at three months, because reinfection is common.
Where to go
A regular doctor, a community health center, a family planning clinic and the county health department all test, often free or on a sliding scale. If you are on a parent's insurance, the statement may go to the policyholder, so ask about confidential billing first.
Note Condoms, the HPV and hepatitis B vaccines, and HIV prevention medication, called PrEP, each lower your risk substantially. Ask about all three at the same visit.
