Online STD testing may be a concept that is new to many, however, as the incidence rate of sexually transmitted diseases (STDs) continues to rise, so too does the number of people who are seeking out different STD testing options.

As an Infectious Disease Specialist, my role involves screening, treating, and educating people about sexually transmitted infections and sexual health.

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Dr. Maryam Mahmood is an Infectious Disease Specialist in Rochester, Minnesota and affiliates with Mayo Clinic. Dr. Maryam is also a member of the LetsGetChecked advisory board specializing in topics related to infectious disease.

Today, I want to discuss your options when it comes to STD testing, and in particular, online STD testing. Before we get started on the testing process, I want to touch briefly on the symptoms, causes, risk factors and treatment options for sexually transmitted diseases.


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What Is An STD?


An STD (Sexually Transmitted Disease) is an infection that you can acquire through sexual contact. This includes bacterial infections like chlamydia, gonorrhea and syphilis, as well as viral infections like herpes or HIV.

It’s important to realize that you may not have symptoms with many STDs and so regular screening can help catch these infections early before they cause serious or permanent problems.

STDs can be cured or managed with medications prescribed by a doctor. Regular STD screening and treatment can also help reduce the chances of passing on an STD to other sexual partners and reduce STD rates in your community.

The incidence of STDs has been increasing since 2013 in the United States and this trend will probably continue into 2019 as well. What's even more alarming is that the United States has the highest rate of sexually transmitted infections in the industrialized world. The rising rates of STDs is being seen across all age groups, genders, ethnicities and throughout many areas of the United States.

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Let's take a quick look at some of the most common sexually transmitted diseases.

Chlamydia, gonorrhea and syphilis

Chlamydia, gonorrhea, and syphilis are all common STDs that can be passed through vaginal, oral, or anal sex to both men and women. Over the last few years the rates of chlamydia, gonorrhea and syphilis have all been rising. Untreated chlamydia and gonorrhea can cause fertility problems for both men and women, these infections may not have any obvious symptoms so regular screening is important if you’re sexually active. If you’ve had these infections before and been treated you are still at risk for getting these infections again if you have another sexual exposure.

We also know that the rates of antibiotic resistant gonorrhea are increasing, not just in the United States, but worldwide. If this trend continues it may become more difficult to treat gonorrhea with antibiotics. It’s also worrying that with the rise in syphilis rates, we’re seeing more congenital syphilis in infants born to women with undiagnosed and untreated infection. Syphilis is easy to cure in the early stages of infection with a course of antibiotics.

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HIV

HIV is another STD which can cause serious disease. The rates of HIV in the United States have been stable, but not decreasing, over the past several years. HIV is a virus which is spread through sexual contact, infected blood and some body fluids. HIV attacks your immune system and makes you more prone to getting infections and some cancers. If HIV is caught early there are very effective medications that can control the virus and stop it from causing disease or damage to the body. Untreated HIV causes progressively more damage to the immune system, eventually leading to acquired immunodeficiency syndrome, or AIDS, which can be fatal. It’s also important for people to know that if you have HIV and another STD, you are more likely to pass on HIV to your sexual partners.

Hepatitis B & C

Hepatitis B and hepatitis C are viruses which can cause liver inflammation, liver damage or cirrhosis, as well as liver cancer. Both of these, as well as hepatitis A infection, can be transmitted through sex or exposure to blood and other body fluids. There are very effective vaccines available to prevent hepatitis A and B infection. There are also very effective treatments for hepatitis C infection.

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LetsGetChecked offer a full suite of at home STD testing options so that you can better track and understand your sexual health from the comfort of home.

H.P.V.

H.P.V. or human papillomavirus is an STD that causes genital warts, cervical, vulvar, and vaginal cancers in women, penile cancers in men, as well as oral and anal cancers in both men and women. There is a vaccine against the most common types of HPV that prevent the majority of HPV related infections and cancers. We recommend women under 26 years and men under 21 years receive the HPV vaccine to reduce the chances of getting these serious HPV related cancers. There is also good evidence that vaccinating men and women up to the age of 45 years can reduce the chances of getting these serious cancers. The widespread use of the HPV vaccine in some countries like Australia could lead to cervical cancer being eradicated in the near future in these places.


What Are The Risk Factors Associated With STDs?


Everyone who has sex is at risk for STDs. The risk of getting an STD is greater if you don’t use condoms during sex, have multiple sexual partners, have a new sexual partner, or have sexual encounters under the influence of drugs or alcohol. We also know that young people, as well as gay/bisexual men are at higher risk of getting STDs.

It’s important to have an open and honest conversation about your sexual behaviors with your healthcare provider so that you can have the right tests, treatment, and prevention for STDs. Being able to order STD tests online is another great tool to monitor and improve your sexual health and wellness.


What Are The Symptoms Of an STD?


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Many STDs do not cause symptoms, which is why regular testing is important if you’re sexually active. Common symptoms are genital lesions, penile or vaginal discharge, burning with urination, pain with ejaculation, abdominal pain, or swollen lymph glands in the groin. Some STDs can cause skin rashes or swollen lymph glands all over the body, fevers, or jaundice.

How Do You Know If You Have An STD Without Getting Tested?


Regardless of symptoms we recommend regular STD screening if you are sexually active.

All sexually active women under the age of 25 should be tested for gonorrhea and chlamydia every year even if they do not have symptoms. All women regardless of age with a new sexual partner, multiple sexual partners, or with a sexual partner who has an STD should be tested for gonorrhea and chlamydia every year.

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All men who have sex with men (MSM) should be tested for gonorrhea, chlamydia, or syphilis at least every year. If you have multiple partners you should be tested more often, around every 3-6 months, even if you don’t have symptoms of an STD.

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If you have anal or oral sex, specific tests should also be tested for STDs like gonorrhea and chlamydia. Testing for many STDs can be performed on urine, urethral or cervical swabs, anal swabs, or oral swabs.

We also recommend that everyone gets screened for HIV at least once in their life. If you have unprotected sex, multiple sexual partners, an HIV positive sexual partner, or use injection drugs you should be screened at least every year.

You’re probably wondering about the next steps if you have already taken an STD test and an STD has been detected during this test...

We recommend that you see a doctor to get appropriate treatment for the STD. If you have an STD you should also be tested for other sexually transmitted infections, for instance if you have a positive test for chlamydia, we would suggest that you also get tested for gonorrhea, syphilis, HIV and Hepatitis B.

In general we recommend you abstain from sex until you have completed treatment for the STD for most infections. It’s important that your sexual partners get tested and treated for STDs too.

You’re probably wondering what the next time period for getting re-tested is...

Women who have been treated for gonorrhea or chlamydia should be retested in 3 months because they are at higher risk for reinfection. Pregnant women with chlamydia should be retested 3-4 weeks after treatment, then again 3 months after treatment to reduce the chances of passing on the infection to their baby.

Men who have sex with men, or have multiple female or male partners without using condoms, should also be tested for STDs every 3-6 months.

When it comes to incubation periods…

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How soon you should get tested after a possible exposure depends on the STD - remember that many STDs may remain asymptomatic so it’s important to get screened regularly if you’re sexually active, especially if you have unprotected sexual intercourse, a new partner, or multiple partners.

Testing for gonorrhea and chlamydia using nucleic acid or molecular testing is very sensitive, it can detect a low number of bacteria. The time from exposure to these infections and a positive test depends on the specific test used. In general the incubation period from exposure to symptoms (if they develop) is 1-14 days for gonorrhea and 7-21 days for chlamydia.

If your initial test is negative after an exposure, consider getting retested two weeks later.

The time from exposure to a positive HIV test is 2 weeks for the newest fourth generation HIV tests. If you think you’ve recently been exposed to HIV a different blood test may be able to detect this earlier and you should see a doctor as soon as possible to have this testing performed.


What Is The Best Prevention For Sexually Transmitted Disease?


Using condoms consistently is the best way to reduce your chances of not getting an STD.

If you’re in a relationship it’s important to have an open and honest discussion with your partner about being screened for STDs if you are thinking about having sex without condoms or if one or both of you are interested in having multiple sexual partners.

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Some people may also benefit from using a medication called PREP every day to prevent HIV.

Consider getting vaccinated against HPV, hepatitis A or hepatitis B - talk to your doctor about whether you may be at higher risk of these infections because of your sexual behaviors.

It’s important to realize that not using condoms, having multiple sexual partners, having sex while using alcohol or drugs, or using commercial sex workers places you at higher risk of getting an STD.

In terms of some of the contributing factors that could lead to better sexual health...

Being aware of how STDs are transmitted, the importance of routine testing if you are sexually active, and recognizing the importance of consistent condom use are all important to improving sexual health.

Sexual health education that is based on scientific evidence is an important part of the positive development of sexual health in our communities.

Accurate and comprehensive education and skill development allows young people to make informed, responsible decisions about their sexual health.

We know that evidence based sexual health education reduces sexual risk behaviors, unintended pregnancy and STDs.

Currently the approach to sexual health education in schools in the US is not standardized or necessarily based on evidence or practical skills. Upto three quarters of high schools in the US choose to focus on abstinence as the main or major part of their sexual health education; this approach is associated with higher teen pregnancy rates.

Removing stigma from sexuality and sexual health is an important part of reducing STD rates. Focusing on negative consequences such as unintended pregnancy or STDs impacts on people's willingness and comfort in seeking out sexual health screening.

A key part of reducing STDs and improving sexual health awareness is consistent and effective funding for STD prevention and treatment programs. Federal funding for public health infrastructure has decreased over the past several years. Decreased access to healthcare is associated with increased rates of STDs and poorer health outcomes in general.


How Will Online STD Testing Options Make A Difference Moving Forward?


Online STD testing options will offer people convenience so they can take the test from home.

For those who would be embarrassed to have a face to face in a clinic, it is something that would also be more beneficial for them.

Moving forward, being aware of the impact of your sexual behaviors, being open with your sexual partners and healthcare providers, and being educated about sexual health and disease are all important for improving your health and wellness.

LetsGetChecked offer a service that allows you to engage with STD testing from the comfort of home.

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Read: Can STD Symptoms Appear The Next Day?


Written by Dr. Maryam Mahmood | Edited by Hannah Kingston