How soon after sex should I have STI testing done?
February 17, 2014 7:49 PM   Subscribe

I (late 20s male) slept with a girl I don't know very well over the weekend. (Used protection, nothing broke or leaked...all very safe.) We talked after, and she said that the last time she was tested she was clean, but that was a while (and a couple of partners) ago. I have no reason to suspect I've acquired anything new, but I'd still like to do my due diligence and make sure I'm clean. My last test was about a year and a half after the last time I'd had sex, but I don't intend on waiting nearly that long. I know HIV takes about six months to show up, but as far as other common STIs go, how long should I wait for anything else to show up?
posted by anonymous to Health & Fitness (9 answers total) 2 users marked this as a favorite
Get tested now, and then get tested again in 3 weeks, 3 months, and 6 months. You don't need to wait to get tested. Get in the habit of being tested regularly.
posted by Jairus at 8:00 PM on February 17, 2014 [2 favorites]

Here you go.

In short, if you want to do everything in one fell swoop and have the best accuracy for all of them, go at 3 months. If you want to go earlier, two of most common ones are detected with highest accuracy at 1 month (chlamydia and gonorrhea). I wouldn't be worried at all about waiting 3 months after a single incident of protected sex, but that's up to you.
posted by randomnity at 8:40 PM on February 17, 2014 [2 favorites]

Do it now for peace of mind. Do it later for ultimate knowledge.
posted by oceanjesse at 9:36 PM on February 17, 2014 [2 favorites]

First and foremost, people with STDs are not dirty, so please do not use the word "clean" as a means of describing yourself or someone else as STD-free. "Clear" is better. "Free" is best.

Second, I was in this position about 1.5 years ago after being raped. I waited to get tested for a year and I wish I hadn't -- not because I have turned out to be HIV positive, but because as it turns out I have some sort of cervical abnormality that may be due to some other STD (courtesy of my rapist, that gift giver). You will feel so much better getting tested now and then getting tested again in 6 months. Just do it and get a baseline started. It's better to be clued in then clued out.
posted by These Birds of a Feather at 10:27 PM on February 17, 2014 [13 favorites]

Keep in mind that if you are using your insurance at your doctor as opposed to going somewhere like Planned Parenthood, your doctor is unlikely to give you multiple std tests a year if you don't have symptoms.

I've had a shocking amount of friends straight out denied std tests by their doctors because they were in low risk populations and didn't have symptoms. So if you opt for the 3 weeks, 3 months etc do you research and find a free/low cost clinic to go to instead of your doctor.
posted by whoaali at 4:19 AM on February 18, 2014 [1 favorite]

I don't know if things have changed at PP, but I was twice denied (and shamed) testing at PP because I wasn't having risky enough sex. So good timing and framing of your sexual history may be key.
posted by MonsieurBon at 9:19 AM on February 18, 2014

Some of the tests for HIV are a lot more sensitive nowadays than they used to be, and can pick up the virus (or its biomarkers) much earlier. You can even buy saliva-based tests for HIV that you can use at home, e.g. OraQuick, off of Amazon. They cost about $40, are very nearly as accurate as blood-based tests, and become effective in the majority of people at 3 months with maximum effectiveness coming at 6 months. Those are an option if you have an issue getting your doctor or a clinic to test you as thoroughly as you'd like.

The other big viral one is herpes of course, but there's not a good test for that unless you come down with symptoms. There's an antibody test for herpes, but it only detects exposure, not infection. Many people get exposed to herpes but then successfully fight it off rather than becoming infected, and the antibody test comes up positive for those people even though they're not carrying the virus. If you develop sores then you can get those tested for the viral particles themselves.

Bacterial infections like chlamydia, gonorrhea, and syphilis can be detected via a culture swab that the doctor inserts into your urethra. As far as I know they are effective more or less immediately (within a few days, anyway) of the patient's being infected. Those diseases are also all treatable with antibiotics.

I'm less sure about what the deal is with the various hepatitises. Do some research, ask your doctor. I don't think your chances of having been infected with hepatitis are going to be very high though, if you used proper protection.
posted by Scientist at 10:04 AM on February 18, 2014 [1 favorite]

Just to point out that as a male who had protected sex with a female, your risk of having contracted HIV is so minuscule it's effectively nonexistent. I certainly wouldn't plan your testing timeline around that.
posted by désoeuvrée at 1:54 PM on February 18, 2014

Okay, so there's a few things that are incorrect here.

Let's start with HIV.

As with all viruses, there is a period between exposure and infection, and the ability to detect whether someone has been infected. This is known as the 'window period,' and in HIV that is 90 days.

Now, when you get tested after 90 days they are not testing directly for the virus in most cases. They are testing for HIV antibodies. Those take time to build up to detectable levels in your bloodstream after seroconversion. In all cases I'm aware of, a positive HIV antibody test will be double-checked with another test, usually directly for the virus. Blood-draw HIV antibody tests, whether directly from the vein or using the rapid finger-prick test, are virtually 100% effective. The finger-prick rapid test has a tiny chance of throwing a false positive, but AFAIK does not produce false negatives since it was reformulated approximately twelve years ago.

So. 90 days from possible exposure is when you want to get tested for HIV. Agreed that protected hetero PIV sex has a vanishingly tiny chance of HIV infection, but if you're sexually active it behooves you to know your status anyway. Personally I get checked once a year, but up here we have clinics that are free to use and explicitly set up to handle preventive care as well as treating infections.

Other diseases:

Chlamydia and gonorrhea can be detected after 10-14 days (per conversations when getting tested at the link I gave above). You don't need to wait a month. For genital C/G infections, you can either have a urethral swab (it's not really painful, just briefly uncomfortable) or you can pee in a cup. Make sure you contact the clinic/doctor where you are getting tested beforehand, because you need to give them the first pee of the day if you're going that route. You should also get oral swabs for both, as both can be transmitted by oral sex. I can't remember which way round it is, but either gonorrhea or chlamydia is a single pill, get tested again ten days later to be sure you're clear, and you're fine. The other is a several day course of antibiotics, and again retest to ensure the infection is gone.

Bear in mind also that something like 50% of men can carry gonorrhea and/or chlamydia while remaining asymptomatic. So lack of symptoms isn't the same as lack of infection.

Any STI screening should include a visual examination by the clinician to look for signs of infection (e.g. pus/discharge) as well as signs of HPV, herpes, molloscum, crabs, etc.

I can't remember the incubation period for syphilis, but I seem to recall it's also about 14 days. Take that with a grain of salt and not as gospel please. Syphilis has been on the rise (again) in MSM communities, so it's worth getting checked for--unless the girl you slept with was a virgin, it's entirely probable that she's had sex with MSM.

Bear in mind that depending on where you live, some STIs are required to be reported to public health. In Canada we have anonymous HIV testing for exactly that reason, though gonorrhea, chlamydia, and syphilis have to be reported to public health when a positive test occurs, to allow them to contact previous partners (anonymously; the Hassle Free Clinic's approach is to let you know that someone you had sexual contact with in the previous two years has tested positive for X, so why don't you come in on Tuesday and get checked), and to halt the spread of infection. This is not an argument for not getting tested obviously! Just letting you know. I am unaware of how positive STI test impact insurance, if you're in the USA.

If you have further questions, the link I gave above will give you an excellent rundown on what to get tested for and when and why. If you ever use craigslist, they provide links in (at least the M4M sections) to sexual health resources.

All in all, you're probably fine and right as rain. But it's a good idea to get checked out from time to time if you're sexually active. If nothing else, if you do pick something up, regular testing allows you to narrow the field considerably and only contact the people who need to be contacted.
posted by feckless fecal fear mongering at 10:00 AM on February 19, 2014

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