Sexually transmitted infections (STIs) are no laughing matter, but we need to talk about them.
STIs can happen to anyone. If you have sex, you are at risk. About one in five people in the United States currently has an STD, and if you think reality TV is only about 20-somethings, think again. Diagnosis rates have increased in people aged 35 and over.
In a perfect world, everyone would talk to their doctor about STDs, get treatment if needed, and update their partner about their current status. But the world isn’t perfect and many people don’t even know they have a sexually transmitted infection because they don’t have any symptoms.
The best thing you can do for yourself and your partner? Get tested.
Here’s what you need to know about sexually transmitted infections, STI testing, and the newer technologies that are helping women be more proactive about their sexual health.
What are sexually transmitted diseases?
STIs are caused by viruses, parasites and bacteria and are primarily transmitted through vaginal, anal and oral sex. However, some sexually transmitted diseases can be transmitted through skin-to-skin contact.
HIV and the bacteria that cause syphilis can also be transmitted from one person to another during pregnancy, childbirth, intravenous drug use, and blood transfusions.
STDs are common, so it’s no surprise that there are more than 20 types of infections.
STIs can include:
Why should you get tested for sexually transmitted infections?
If you have sex, you are at risk of contracting a sexually transmitted disease.
It’s important to get tested because many sexually transmitted diseases don’t cause any symptoms, so you may be spreading the infection to other people without even knowing it.
STIs can also lead to serious health problems such as cancer and infertility without proper treatment.
When should you get tested for sexually transmitted infections?
When to get tested and which STDs you should get tested for may depend on several factors, including your age, sexual activity, sexual history, and whether you have symptoms of an STD.
Symptoms of sexually transmitted diseases in women may include:
- Abnormal vaginal discharge (color, smell, consistency that is unusual for you)
- Warts in the genital area
- Sores or blisters in the mouth or genital area
- Burning feeling when peeing
- Itching or redness in/around the vagina and/or anus
- Fever
- stomach pain
If you have symptoms, talk to your doctor immediately about testing options.
If you are sexually active and have no symptoms of an STD, talk to your doctor about your risk factors, testing options, and how often you should be tested.
General STI testing guidelines include:
- All sexually active women under 25 should be tested for gonorrhea and chlamydia at least once a year
- Women age 25 and older who have new sexual partners, have multiple partners, or have a partner with a sexually transmitted disease should be tested for gonorrhea and chlamydia at least once a year
- Everyone between the ages of 13 and 64 should be tested for HIV at least once in their life
- Women in early pregnancy should be tested for gonorrhea, chlamydia, hepatitis B, hepatitis C, syphilis and HIV
- Get tested for syphilis if you live in a high-risk area
- People who have anal and/or oral sex should talk to their doctor about throat and rectal testing options
In addition to testing, you can protect yourself from sexually transmitted diseases by using condoms or dental dams every time you have sex. DoxyPEP, the use of a specific dose of the antibiotic doxycycline, can help prevent some bacterial infections after exposure, and two antiretroviral drugs – PrEP and HIV PEP – can help prevent HIV infection.
What are the dangers of unrecognized sexually transmitted infections?
If left untreated, sexually transmitted diseases can cause serious health problems, including:
- infertility
- Cancer
- Increased risk of HIV/AIDS
The effects of untreated sexually transmitted diseases tend to be more severe in women than in men.
For example, untreated chlamydia and gonorrhea in women can lead to pelvic inflammatory disease, which can lead to ectopic pregnancies, infertility, and chronic pelvic pain.
What are nucleic acid amplification tests for STIs?
Today, nucleic acid amplification tests (NAATs), which can be performed using a vaginal swab or urine sample, are the gold standard for testing many sexually transmitted diseases due to their high sensitivity and ability to detect infections.
NAATs can detect small amounts of nucleic acid (DNA or RNA) from STI pathogens, even in the absence of symptoms. For example, a NAAT for chlamydia looks for Chlamydia trachomatis nucleic acid in the sample. Since most women don’t have any symptoms of chlamydia, a test is the only way to detect it.
Although most doctors already use NAATs for bacterial STI testing, you can specifically request a NAAT during the exam.
NAATs provide quick results and are extremely accurate. Another advantage is the ability to self-swab: NAATs can be used with self-collected samples in a clinic or at home, so you don’t necessarily need a doctor to collect the sample. If you are diagnosed with an STI, you must contact a doctor for treatment.
Most home collection kits for sexually transmitted diseases require you to mail in the sample, but last year the FDA approved the first home test for chlamydia, gonorrhea and trichomoniasis that has its own testing device. The results are available in about 30 minutes – there is no need to send them by post.
Are nucleic acid amplification tests covered by insurance?
Most health insurance plans will cover NAATs for sexually transmitted diseases if you are tested by a doctor, but coverage can vary. And depending on your plan, not all STDs may be covered.
NAATs for STDs without symptoms are typically referred to as preventive treatment, meaning they are covered.
However, if you have symptoms, NAATs may no longer be considered preventive and you may have to pay for the tests out of pocket.
To avoid surprises, talk to your doctor or contact your insurer to find out what tests are covered and how much you may have to pay out of pocket.
NAAT home testing kits are typically not covered by insurance.
If NAATs are not covered by your insurance, check with your local health department or community health center about low-cost or no-cost options that may be available to you.
This educational resource was created with support from Hologic, a member of the HealthyWomen Corporate Advisory Council.
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