Getting Tested For STDs: Everything You Need to Know


What exactly happens during a test? What are the different STD tests like?

Doctor’s visits are already daunting, but going to the gynecologist for the first time without knowing what to expect adds even more stress. But don’t worry, collegiettes, because we (with the help of Dr. Brooks, of course) have broken down the tests you may encounter so that you’ll be cool, calm, collected and informed.

Pap Smear (Papanicolaou Test)
Tests For: Signs of an HPV infection and cervical cancer
What Happens: “The provider takes a spatula and rims it around the edge of the cervix, then uses a brush that looks just like a mascara wand to take a sample from within the cervix itself. We can also use a "broom" that takes care of both of those steps in one. Those samples are then placed into a jar of fixative and sent to the lab where they are read by a pathologist looking for any abnormal cells. Having an abnormality DOES NOT automatically mean that you have cervical cancer. The pap is just a screening test,” says Dr. Brooks, who says that, depending on what is found in the screening, this could mean a repeat of the test 6-12 months later or a colposcopy.

While doctors recommend getting a Pap Smear when you turn 21, the HPV vaccine is a great preventative measure against infection, so be sure to ask about it during your next appointment or walk-in. “Encourage male partners to get it too, since there is no equivalent test to the pap for guys,” Dr. Brooks adds.

Blood Sample
Tests for: HIV, Syphilis, Hepatitis B and C, and Herpes
What Happens: The process is simple—just a prick of a needle—and the sample of blood will reveal if you have the antibodies caused by the infections listed above. “Antibodies are proteins that your body makes if you have been exposed to something,” Dr. Brooks explains. “Because of that, it may actually take several days to weeks to months to start making antibodies in any appreciable amount. If someone's HIV antibody is positive, a more detailed test is then run to confirm the prevalence of HIV. For HIV and hepatitis we can actually check for the ‘viral load,’ which is the concentration of those viruses in blood. A rapid (within 20 minutes) HIV test is available at many testing sites.” Since it can take several days or weeks until the antibodies can be detected, if you think you have been exposed to an STD and then get a blood sample immediately but test negative, it is important that you get another test a few weeks down the road to be certain.

Urine Sample
Tests for: Gonorrhea and Chlamydia
What happens: To put it simply, this test consists of peeing in a cup. “Urine [sampling] is what we call a ‘first void dirty catch,’ meaning that is has to be the first 20-30cc of urine without wiping with cleansing cloths first, says Dr. Brooks. “Even though those STDs live on the cervix, because the urethra is so close to the vagina, [gonorrhea and chlamydia] will be colonized in the urine as well.”

Vaginal Sample
Tests for: Gonorrhea, Chlamydia, Herpes, and other non-STD bacterial infections
What happens: A speculum is used to insert a swab into the vagina to collect vaginal fluids, which are later tested under a microscope. Color, consistency, and smell are all factors in determining what type of infection you may have. “We can also use special swabs with viral culture media to try to grow herpes from any suspicious lesions,” Brooks says. This test should not be done while you are on your period, so plan for this accordingly.

A UMich collegiette had a herpes scare when she found a series of bumps on her upper inner thigh, so she went to her university’s health center. “The nurse said the bumps looked like herpes, so she took a viral culture of one of the them (meaning she lightly scraped it with a swab which is then tested; it hurt a tiny bit because bumps were sensitive and painful to touch, and [she] said the results would be back in a few days. Getting the call and waiting to hear the results was unbearably nerve-wracking. I felt like I was going to cry and throw up and faint all at once. Surprisingly the story has a happy ending… the results came back negative! Being paranoid and having spent the last few days convinced that I had herpes, I was scared that it was a false negative or something so I also got a blood test a few weeks later to make sure.”

Thankfully this collegiette tested negative the second time around, too—but, again, it’s always a good idea to be extra-sure when it comes to your health!

Is it covered by insurance?

Yes, but if it is not covered in full, the cost is usually $10 to $30 per test. Many University Health Services and clinics like Planned Parenthood offer free testing.

“Most insurance programs strongly recommend testing for teens and young adults and cover it fully. In fact, I will often get reminder letters from the insurance carriers to test patients in that age range if they have never been tested!” Dr. Brooks says.

Will my parents know if I go?

Not all of us want to have an Ileana-Ryan Lochte relationship with our moms. And while the Health Insurance Portability and Accessibility Act (HIPPA) protects the privacy of your health records, there are a few exceptions depending on your insurance.
 

“If you are still on your parents' insurance but are over 18, many times you can call the company yourself and ask to not have data released to your parents,” Dr. Brooks recommends. “Almost all of the companies have stopped sending those types of receipts (called EOBs, or Explanation of Benefits) home anyway just for this reason, no matter what the age. If someone really wants to be sure that it will be fully confidential, she should make sure that the clinic is listed as a Title X provider. This is a nationwide federal program that enables women who otherwise would have trouble with access to be able to get testing and contraceptives, at reduced cost or even free.”

So, again, it’s a good idea to research the clinics in your area to make sure that you’re not only receiving the best care, but also the confidentiality you want. And of course, it’s always an option to double check with your doctor once you’re at your appointment.

What should you do based on the results?

Whether the results are positive or negative, you should be able to share this information with your partner—your health and your partner’s health are interdependent. This means that when it comes to test results, there should be an agreement of absolute transparency. “A lot of couples each will get tested and then share the results. I am asked to directly print the results out quite often so patients have ‘proof,’” Dr. Brooks says.

If the results come back positive, your doctor or nurse will help you determine what measures to take based on the degree of the STD. The treatments range, according to Brooks, from antibiotics (Chlamydia – one dose of Azithromycin 1000mg orally) to a shot (like ceftriaxone 250 mg for Gonorrhea, which is injected as a shot into the buttock) to abstinence (true of both Chlamydia and Gonorrhea for about a week). During this difficult time when your health is in danger and your sexual freedom is limited, it’s important to lean on someone for support, whether that someone is a friend, a family member, a therapist, or your partner. You can also seek out an online support group if you do not feel comfortable confiding with someone in person. Remember the 1 in 2 statistic by age 25: testing positive is not something to be ashamed of nor is it something you have to go through alone.

So what are the main takeaway points?

  1. Always be proactive when it comes to your health, even if it means going to get tested multiple times a year
  2. Make sure you and your partner stay updated and open when it comes to your sexual histories
  3. Even if you want your results to be private, seek emotional comfort in the people you trust. Being vigilant about your physical health now will ensure a healthy future, and that, collegiettes, is something you can be sure you won’t regret.