Having sex can be an amazing thing, but what’s more amazing is having safe, healthy sex. Part of that is making sure you and your partner(s) get tested regularly for STIs. Just like your first time having sex was a little intimidating, so can your first time being tested for STIs. That’s why I decided to interview Dr. Laura Burkhart and ask her to help me debunk common stigmas and ideas surrounding STI testing.
How long have you been in the medical field/ performing sexual health check ups?
I have been working in the medical field for 8.5 years. I have been at Vanderbilt Student Health Center for 2.5 years, where we do quite a bit of sexual health exams including STI testing and birth control. Prior to working at Vanderbilt, I did an Adolescent Medicine Fellowship for 3 years at University of Washington/Seattle Children’s Hospital, where a large focus was on sexual health, so this is within my specialty as well.
What is tested for during routine testing?
It really depends on the individual and their practices, which can be different for everyone. When someone comes in for routine testing, your medical provider will ask you questions about your history to determine what needs to be tested for. One thing I always tell people is to not assume that they were automatically checked for something on a previous visit. Some STIs are not routinely tested for unless you are having certain symptoms or have had specific exposures. It is always okay to ask what you are being tested for, and in fact I encourage people to ask.
What does a routine STI testing involve? What tools are used for this?
STI testing can feel quite intimidating at first, but it really doesn’t need to be. Routine testing, meaning someone is not having any symptoms, usually involves either a urine test or vaginal swab (this can be done without a pelvic exam, as we can use “self-swabs” now), but depending on your partners and practices, can also be a throat swab and rectal swab. Usually a blood test will be recommended, especially if you have not been checked for HIV or syphilis before.
If there are STIs that are not routinely checked, when should I ask my provider to check for them?
Certain STIs such as herpes, can be difficult to accurately test for unless you have an outbreak, so certainly if you are experiencing any symptoms then it is important to let your medical provider know and talk through what STIs might present that way. Certain symptoms many people would know to look out for such as an unusual vaginal, penile or rectal discharge, genital rash, painful urination, abdominal or pelvic pain. But certain STIs such as HIV, can have a more subtle presentation and can be mistaken for the flu or another viral illness.
When should I get tested?
This can also depend on the individual and their practices. Certainly, if you are experiencing any worrisome symptoms or have a partner contact you that they have be diagnosed with a STI. If you have a new partner and you anticipate no other partners while you are with them, then that would be a perfect time to come in as well. For some people who have multiple partners, then we typically recommend coming in every 3 months for testing, unless of course someone is experiencing symptoms or have a known exposure to an STI.
How much does it cost?
This can depend on the insurance plan. At Vanderbilt, if you have the Student Health insurance, then many of the STI testing is free or low cost. At the Student Health Center, we offer testing that students can pay for out of pocket at a reduced cost, as there are many students who do not want to bill their insurance. If you have private insurance, you always have the option to bill your insurance, but every plan is different on how much they might bill you.
Can people get more than one STI at a time?
Yes, great question. It is very possible to have more than one STI at a time, which is why we end up testing for multiple infections even if someone is not experiencing symptoms at the time.
Do health care professionals view people who get STI testing a certain way? How can we help get rid of the stigma around STI Testing and the idea that only “dirty” people get screened?
Unfortunately, this is still a misconception that even some health care professionals carry with them and might not even realize they do. Medical training is changing in how these topics are presented and learned about, so the hope is that this will cause a cultural shift in the upcoming generations. No one should ever feel judged or shamed when they come in, and everyone deserves to have a medical provider who can offer that type of open and welcoming environment. I try and normalize STI testing as much as possible and empower people that being tested is an important advocacy for your health, just like any other part of your body. When someone does test positive for an STI, I also feel it is important to remember, that an STI is not a “punishment”, and they should never feel it is a reflection on who they are as a person, or their identity. I think once medical professionals and society understand that idea, then this stigma of STIs will be a thing of the past, where it belongs.
I would like to extend my warmest thank you to Dr. Burkhart for helping dispel some common ideas and worries surrounding STI testing. Safe sex practices don’t need to be scary or intimidating, and it falls on us to help change the stigma around them. To make an appointment for routine STI testing at Vanderbilt Student Health Center call the office or log on to your My Health at Vanderbilt portal and schedule one today.