Currently in the US, STD testing is very erratic, and I've noticed that a lot of default panels for testing totally neglect Chlamydia and HPV for women. That's unfortunate.
Mayo Clinic Guidelines in 2 Pages/Testing Frequency
http://www.mayoclinic.com/health/std-testing/ID00047
STDs and When to Test
http://depts.washington.edu/nnptc/online_training/FINAL%20STI%20Screening%201_2012.pdf
Further, you can access National HIV and STD Testing Resources at this website:
http://www.hivtest.org Again those resources are for STDs including but not limited to HIV.I put in my zip code and used the milage pulldown and found 10 clinics exclusive of the hundreds private primary care (IM, FP, OBGYN) or ID MDs that I know of in my area.
Generally, testing includes HIV, and Hepatitis B and C, and Chlamydia. No HPV screening test is available for men, in whom the infection is diagnosed only by visual inspection or biopsy of genital warts.
The Centers for Disease Control and Prevention (CDC) encourages HIV testing, at least once, as a routine part of medical care if you're an adolescent or adult between the ages of 13 and 64. The CDC advises yearly HIV testing if you are at high risk of infection.
Request testing for HIV, syphilis and hepatitis if you:
Test positive for gonorrhea or chlamydia, which puts you at greater risk of other STDs
Have had more than one sexual partner since your last test
Use intravenous (IV) drugs
Or a man who has sex with men
No good screening test exists for Herpes, a viral infection that can be transmitted even when an infected person doesn't have symptoms. Your doctor may take a tissue scraping or culture of blisters or early ulcers, if you have them, for examination in a laboratory. But a negative test doesn't rule out herpes as a cause for genital ulcerations.
A blood test also may help detect a herpes infection, but results aren't always conclusive
Type 1 is the virus that more typically causes cold sores, although it can also cause genital sores. Type 2 is the virus that more typically causes genital sores. Still, the results may not be totally clear, depending on the sensitivity of the test and the stage of the infection. False-positive and false-negative results are possible.
Besides Pap Tests according to guidelines, all women should be tested for HPV. Virtually all cervical cancers are now known to be caused by HPV. There are 100 types of HPV, , and some of them are more high risk for cervical cancer than others. The most common of the high-risk strains of HPV are types 16 and 18, which cause about 70% of all cervical cancers. HPV produces viral proteins that interfere with cell physiology that limits cell growth.
If the body clears the infection, the cervical cells return to normal. But if the body doesn't clear the infection, the cells in the cervix can continue to change abnormally. This can lead to precancerous changes or cervical cancer.
If abnormal cervical tissue changes progress, treatment of the HPV infection may be needed. Among the options are surgery, laser treatment, and freezing.
When infection with high-risk HPV types occurs, there are usually no symptoms.
A big component of what is really ***crucial*** as to STD testing I've pointed out before and I'll do it again. ***What's important besides whatever the risk factors are in your particular situation are the time windows where an individual is negative i.e. seronegative for a particular test because of the incubation period of that particular virus in most cases and bacteria in a few.*** We're talking about basic virology here that MDs are suppose to learn to apply to testing their patients. And believe me there are hundreds of resources for this that show up in an MD's inbox every day.
Here are two examples for you using three diseases that are prevelant as STDs, HIV, Hepatitis B and Hepatitis C:
HIV
***HIV can be seronegative (i.e. it's not going to show up in any test that you do) from 4 weeks to 6 months.*** Yes that's a big variation in each individual, and that governs how frequently you test. And it goes without saying that using a condom during vaginal sex between a male and female is very effective in preventing transmission of all STDS, but nothing is 100% except abstention, and this website is not frequented by people who are believers in abstention. I'm sure I have that right.
For HIV Acute infection, or acute retroviral syndrome, lasts for 6-12 weeks until anti-HIV antibodies are detectable.Initially, HIV infection produces a mild disease that is self-limiting. This is not seen in all patients and about 30% remain asymptomatic during the initial period of infection. In the period immediately after infection, virus titer rises (about 4 to 11 days after infection) and continues at a high level over a period of a few weeks (figure 4). The patient often experiences some mononucleosis-like symptoms (fever, rash, swollen lymph glands) but none of these is life-threatening. There is an initial fall in the number of CD4+ cells and a rise in CD8+ cells but they quickly return to near normal. At this stage virus titers are very high with as many as one hundred million virus particles per milliliter of plasma.
I'm being about as specific I can. I hope this helps.
Good luck,
JeffEng16
Hepatitis B and Hepatitis C
Hep B has a latency period for detection of 6 weeks to 6 months; and Hepatitis C has one from 4 weeks to 6 months. 60-80 % of patients with Hepatitis C go on to get chronic cirrhosis and fibrosis of the liver, and a smaller percent to be sure get hepatocellular carcinoma.
Hepatitis C should be tested in any Hepatitis testing situation, and its transmission as an STD is greater than 10% in current CDC surveillance as the only cause of Hepatitis C in that population, and it is a growing concern and focus of research in the infectious disease community, gastroenterologists, primary care MDs, the CDC, the WHO, NIH, and hepatitis research centers in medical centers.Hep C sexual transmission was regarded as rare years ago, and you may read incorrect information that still calls it "rare." 10% of CDC surveillance shows Hep C is an STD as the only means of transmission, and that is not statistically "rare" in medical surveillance.
The reason I'm making this point is that transmission of a Heptatis C as an STD, once regarded as rare, is growing and any case of Hepatitis C has as high as an 30 transition to significant liver function compromise and or chirrhosis for life, and it is the leading reason for liver transplatation and we have far too few livers and a long painful waiting list of candidates for transplantation now. About 80% of Hep C patients are chronically infected. 10-30% develop cirrhosis over time. Those who do develop cirrhosis have a 20X risk of hepatocellular carcinoma, or 1-3% of infected patients.
CDC now estimates that Hepatitis C can be sexually transmitted. A big component of what is really ***crucial*** as to STD testing I've pointed out before and I'll do it again. ***What's important besides whatever the risk factors are in your particular situation are the time windows where an individual is negative i.e. seronegative for a particular test because of the incubation period of that particular virus in most cases and bacteria in a few.*** We're talking about basic virology here that MDs are suppose to learn to apply to testing their patients. And believe me there are hundreds of resources for this that show up in an MD's inbox every day.
I would put this in bold font if I could here, because it explains the window of time in which patients are negative for HIV testing.
***There is a "window period" of seronegativity during which an infected person does not give a positive Western Blot HIV test or ELISA, even though the viral load is high and the patient may exhibit some symptoms. This seronegative period can last for six months before seroconversion although the latter usually occurs between one and four weeks after infection.***
By that I mean may or may not show symptoms and diagnostic features of a particular STD, but the viral incubation period is long enough so that a certain amount of time passes before it can be detected by lab tests whether they are sent out or done by the wide array of convenient, fast, tests done in an office or clinic.
Further, you can access National HIV and STD Testing Resources at this website:
http://www.hivtest.org Again those resources are for STDs including but not limited to HIV.I put in my zip code and used the milage pulldown and found 10 clinics exclusive of the hundreds private primary care (IM, FP, OBGYN) or ID MDs that I know of in my area
Again I want to stress the importance of getting to a competent MD, whatever the setting to get a testing MO that fits you.
JeffEng16
I go to a local clinic (Chicago) and get everything tested I can. This is done anonymously (I give them my cell phone number) and they give me the results and a brief counseling session after a brief wait. They say the HIV test shows I was clean 4 weeks (I think that is the number) prior to my visit, and then they ask if I want them to run a second test that takes more time, but will show if I am clean up to a later date, can't remember if it is two weeks before my visit, or if the wait is two weeks and it shows I was clean on the day I was tested. Either way, I say yes and they say they will call me by a certain date if the test is positive, silence means I am clean.
Jeff, are you saying they are misrepresenting the accuracy of the tests, and when the tests show I was clean will vary more than they say? Not a big deal either way, just curious since you seem to know a lot of this.
In the counseling session they go over risk factors for STD transmission, and based on the form I filled out, provide feedback on how safe, or unsafe I am being. They do not seem to have any issue with BBBJ or DATY, aside from strongly suggesting that I not brush or floss my teeth or use any mouthwash for a period of at least 4 hours before meeting, as small abrasions could result in transmission of HIV.
Lastly, I have gotten vaccinations for hep A & B. I know there is no shot for hep C, so that is a risk, but since the transmission of that is usually blood to blood, I do not really consider myself to be very much at risk.
Stick around to get your test results, and if that is not possible, ask them to call your hobby phone or text/email them to you.
zig
Hi ziggy440--
Good questions.
**It would be reasonable for you to HIV test annually, assuming you are having hererosexual sex***
Recommendations for male to male or people with IV drug use are different. This of course does not include the vast majority of hobbyists and providers who practice safe sex.
This is the statement on testing from one of the world's most renowed HIV researchers Dr. Anthony Fauci who has administered the NAID (NIH Infectious Disease Branch) for years and helped lead research efforts for a vaccine with efficacy. He is currently Director of NIH and has been advisor to several presidents on the HIV research effort, H1N1 and other world wide significant infections.
Statement of Anthony S. Fauci, M.D. Director, National Institute of Allergy and Infectious Diseases National Institutes of Health on National HIV Testing Day June 27, 2010
http://www.nih.gov/news/health/jun2010/niaid-28.htm
Dr. Anthony (Tony) Fauci Director NAID NIH
http://www.niaid.nih.gov/about/directors/Pages/default.aspx
Here are the CDC Current Recommendations for Testing (Revised 2006 and yest it is 2012 now but they have not changed them are replaced this recommendation
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm
http://www.cdc.gov/hiv/topics/testing/
It sounds as if you go to a very reliable clinic, and they do a thorough job. However, the serological window of HIV does remain what I said it is. The first test is an ELISA and the second test is a Western Blot. They can take up to 6 months to detect HIV antibody.
There is a "window period" of seronegativity during which an infected person does not give a positive western blot HIV test or ELISA, even though the viral load is high and the patient may exhibit some symptoms. This seronegative period can last for six months before seroconversion although the latter usually occurs between one and four weeks after infection.
To answer your question, you or any clinic that tests, have to contend with this window. Different patients have different incubation periods based on their individual immune mechanisms, and the seronegative period or period in which you got any kind of ELISA tests (most widely used by clinics) and even a followup Western blot could be negative for six months.
There are various RNA tests which detect earlier than these two standard tests, but they still have seronegative windows depending on which test is used and they are not used rotuinely.
RNA tests can detect the virus as early as 7-10 days, but are more expensive, and not widely used because they are more difficult to run. They are offered in most areas. But there have been rare cases reported in the CDC bulletin MMWR for many years in which there is no detectable HIV virus but the patient still has HIV. For example the cases reported in this MMWR:
Persistent Lack of Detectable HIV-1 Antibody In a Person With HIV Infection -- Utah, 1995
http://www.cdc.gov/mmwr/preview/mmwrhtml/00040569.htm
In these cases, and there are others reported from time to time,
"HIV proviral DNA present in the peripheral blood mononuclear cells from the patient and his wife was amplified by a nested polymerase chain reaction (PCR) and sequenced directly. The results indicated that the HIV sequences from the patient and his wife were closely related **, and that these HIV strains were subtype B viruses, the HIV subtype predominant in the United States. Immunologic evaluation of specimens obtained from the patient in August 1995 detected normal levels of serum immunoglobulin G, immunoglobulin M, and immunoglobulin A and a positive immunoglobulin G titer to Epstein-Barr virus and cytomegalovirus."
RNA Testing Not Widely Used
http://www.hivplusmag.com/NewsStory.asp?id=20506&sd=05/11/2009
From CDC's site:
http://www.cdc.gov/hiv/topics/testing/resources/qa/index.htm
"In most cases the EIA (enzyme immunoassay), used on blood drawn from a vein, is the most common screening test used to look for antibodies to HIV. A positive (reactive) EIA must be used with a follow-up (confirmatory) test such as the Western blot to make a positive diagnosis. There are EIA tests that use other body fluids to look for antibodies to HIV. These include
Oral Fluid Tests – use oral fluid (not saliva) that is collected from the mouth using a special collection device. This is an EIA antibody test similar to the standard blood EIA test. A follow-up confirmatory Western blot uses the same oral fluid sample.
Urine Tests – use urine instead of blood. The sensitivity and specificity (accuracy) are somewhat less than that of the blood and oral fluid tests. This is also an EIA antibody test similar to blood EIA tests and requires a follow-up confirmatory Western blot using the same urine sample.
Rapid Tests:
A rapid test is a screening test that produces very quick results, in approximately 20 minutes. Rapid tests use blood from a vein or from a finger stick, or oral fluid, to look for the presence of antibodies to HIV. As is true for all screening tests, a reactive rapid HIV test result must be confirmed with a follow-up confirmatory test before a final diagnosis of infection can be made. These tests have similar accuracy rates as traditional EIA screening tests."
Two points here: Yes there are home testing kits since 1996, and none of them although they get faster and more convenient and now there is an oral swab or as accurate as the above two tests. If they are positive, you could get confirmation but if they are negative, you could still be missing HIV.
RNA tests look for genetic material of the virus and can be used in screening the blood supply and for detection of rare very early infection cases when antibody tests are unable to detect antibodies to HIV. They detect earlier.
Any testing of course does not tell you your past or potential partner's status at a given time.
JeffEng16
My only issue is that there is no test for Herpes. They can test your blood for the antibody but that will be there if you have ever had a fever blister caused by a cold, so it cannot tell you if you have Simplex B or not. This annoys me when bbfs seekers assure you they are clean...hmm really? Well, if you can't test for Herpes unless you have a damn outbreak where the actual lesions are tested, how the fk do you know you are so clean buddy?
