We all want to be safe when it comes to sex, but sometimes it’s hard to know what, exactly, that means or how to go about doing it. One of the main ways you can stay healthy is by getting tested for sexually transmitted infections—but even if you know that that’s something you’re supposed to do, when do you need to do it? Thankfully, Dr. Katharine O'Connell White, Director of Fellowship in Family Planning and Associate Professor at Boston University, has the answers to these questions. Here’s her best advice on how and when to get screened for STIs if you have a vagina:
Do it at least once a year
At minimum, Dr. White recommends going to the gynecologist for a screening at least once a year. But if you’re not sexually monogamous and over 25, you might want to consider getting tested twice a year. “It depends on your age and your activity,” she says. “If you’re 25 years old or younger, we recommend that you get screened once a year. And then if you’re older than 25, you tend to have some kind of a risk factor that may suggest more routine screenings.” But don’t panic—‘risk factor’ doesn’t mean what you think. “High risk does not mean irresponsible behavior, and it certainly doesn’t imply judgment—it’s a cold calculus based on who gets infections,” says Dr. White. “From your doctor’s perspective, having multiple partners at once, or even a new partner are risk factors.” Overall, “the recommendation for annual testing is the minimum, and then you can increase it based on your risk level or your worry level.”
If you see something, say something
“Tests are used for two purposes,” says Dr. White. “Screening, which implies that you feel fine and are just making sure that there isn’t something there, and diagnosis, to figure out what’s going on when something is there.” So what kinds of things are signs that you might want to see your gyno for a diagnosis? According to Dr. White, “a new technicolor discharge, pelvic pain with fever, a lesion, an ulcer on your vulva or warts.” If that happens, it doesn’t matter if you’ve already been in for your annual screening—it’s a good idea to get checked again.
Worried about something? Go and get tested.
If something happens that makes you feel like you want to get an STI screening on top of you annual one—maybe a condom breaks or a partner tells you that they have an STI—go for it. It’s important to feel empowered to get tested as often as you need to feel healthy. The one catch is that it’s best to wait a beat before seeing your doc. “If the condom breaks on Saturday, don’t go to the gyno on Monday,” says Dr. White. “The test won’t be positive yet. There are no good guidelines on when tests would be positive, but waiting a month will increase the chances of detecting anything that you might have picked up.”
Reminder: STI screenings shouldn’t be used in lieu of condoms
Repeat after me: STI tests aren’t an excuse for not using condoms. Even if you think that STI screenings alone will protect you because you can get treated quickly for anything that you find, well, you’re wrong. “That doesn’t protect you from STIs that doctors can’t treat or eradicate, like HIV or Herpes,” says Dr. White. So if you’re not in a sexually monogamous relationship, condoms and screenings are a must.
Get tested annually even if you’re in a sexually monogamous relationship
There are a few reasons for this: firstly, some STIs can be dormant for years and then suddenly pop up, and secondly, it’s a smart idea to, as Dr. White says, “trust but verify. I can’t tell you how many women I’ve taken care of who thought that they were in a monogamous relationship, but weren’t.” That said, getting tested absolutely shouldn’t be a signifier that you don’t trust your partner. “Just look at it like a routine health screening, like you would for blood pressure and cholesterol,” adds Dr. White.
Don’t get it twisted: STI screenings are NOT Pap smears
“A lot of women lump the two together, and whenever they’ve had a pelvic exam of any sort, they think that they’ve had a Pap test,” says Dr. White. “However, it’s much more likely that they’ve had an STI screening.” While STI tests check for infections, Pap smears are done to help prevent cervical cancer—and it’s important that you do both. “The good news is that you only need a Pap smear every three to five years, starting at age 21, regardless of your sexual activity.” And if you’re not sure if you’ve been getting both, don’t be afraid to ask.
Remember to protect your bank account as well as your vagina
If you’ve been thinking, “all of this testing certainly sounds expensive!” well, you have a point. But luckily, you can get your insurance to cover more than one screening a year by simply talking to your doctor. “It’s important to share with your doctor the reasons why you’re worried, because your insurance company won’t pay for more frequent testing unless your doctor uses the code ‘at risk,’” says Dr. White. You don’t have to give details, but let your doctor know why you want another screening.
And even if you forget all of this info (and I get it—there’s a lot here!), remember that at the end of the day, STI testing is also about what feels comfortable to you. Ask questions and go in for more screenings if you need—it’s your health and your life, so protect it.
Protection starts by being prepared, so always keep a stash of condoms on hand!