Newbie

STD testing?
shyguy272 17 Reviews 1844 reads
posted

What STD's do you guys get tested for? I'm new to the hobby and wasn't sure if I should get tested for HIV or what other STD's to get tested for. The place I would go to would be a Planned Parenthood place and wasn't sure how much it would run me, but also what I should get tested for?

Planned Parenthood does a standard STD test for gonnerhea and claymadia for about $40, they do an HIV test for free.

If you want tested for something else like genital warts or trich or whatever, you have to let them know what you want to be tested for that isn't included in their standard test and they will give you the additional fee if there is one.

Nice thing about planned parenthood - if you can't pay the entire bill, they will let you make payments on the balance due.

Anyway give your local Planned Parenthood a call and they will tell you exactly what they test for and how long it takes to get results etc.

Also some PP locations have the female condom available, you can ask if they have any they can send you home with as well.

Shyguy--

What tests YOU need depends entirely on YOUR HISTORY of potential sexually risky behavior and YOUR risk factors

Planned Parenthood is a great organization, and a source of all kinds of screening via physical exams and lab tests, and I hope it continues to be well supported in every state forever. Pap Smears and breast exams as well as hypertension treatment for example, are three staples that their dedicated staffs do to help deliver care to populations who need it at affordable prices. So Naomi has a very useful suggestion there.

When evaluating a patient for what STDS to test for, risk factors should determine what tests you do.  The CDC, and most major clinic environments who deal with this as well as physicians in their offices gear testing recommendations done to the risk factor of the person seeking testing. They divide them into categories and base the testing on studies of populations  of what has shown up in large populations with specific risk factors over time in those categories

So what tests you need at any given point in time depend on your history of potential exposure to specific STDs. In other word, what's the patient's age, past sexual behavior over time, and other risk factors?  Once you know this you can recommend the tests to get.  Subgroups of MSM (Men having sex with men)for example, have a special focus because of their risk factors, as do young adolescents, and a number of other populations.

As has been pointed out correctly by different people at least 3 times in the last few days on this board, even older patients are showing a striking exponential increase in STD risk because of careless behavior.

There are literally thousands of guidelines on the web for which tests you need depending on what risk population you fall into.  This one from Mayo is a reasonable representation of tests keyed to risk factors so take a look and see where you fit:

Mayo Clinic Guidelines in 2 Pages
http://www.mayoclinic.com/health/std-testing/ID00047

Many clinics have packages geared to common risk groups, and many labs offer them as well.

If you google "std testing Atlanta" you'll see a number of clinics who offer inexpensive packages.  Any physician you go to should be able to take your history and guide you to the correct tests that cover your particular risk history.

JeffEng16

-- Modified on 6/8/2012 7:33:41 PM

= HIV, Chlamydia, Gonorrhea, Syphilis, Herpes 1 and 2, and hepatitis B and C

See NCI Fact Sheet HPV:

http://www.cancer.gov/cancertopics/factsheet/Risk/HPV

For women besides an obvious Pap 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. Often, the first clue is a Pap test result that is abnormal.

Any MD doing a Pap Smear should know to get endocervical cells on the brush, because that area is where early cervical cancer starts.

Actual cervical cancer is now much rarer in the U.S. because most women get Pap tests and have abnormal cells treated before they turn into cancer. The American Cancer Society predicts that about 12,170 women will find out they have cervical cancer in the U.S. this year. They also say that roughly 4,220 women will die of the disease the same year.

HPV types associated with genital infections are transmitted sexually, primarily through skin-to-skin contact during sexual activity. HPV can also be spread through oral sex. The chance of getting HPV rises with certain risk factors:

Number of lifetime sexual partners (risk increases with more partners)
Young age: Women aged 20 to 24 are most likely to be infected, but they usually clear the HPV infection with no problems.

Women who are sexually active with men who have other partners at the same time.

HPV has also been linked to cancer of the vulva, vagina, penis and anus. Vaccines can protect both men and women from some types of HPV, but they are most effective when administered before sexual activity begins.

-- Modified on 6/9/2012 10:45:11 AM

JohnISmyname554 reads

Posted By: perfectstorm
= HIV, Chlamydia, Gonorrhea, Syphilis, Herpes 1 and 2, and hepatitis B and C



That quote you pasted left out HPV.  And if you're female, it should be mandatory that you test for it, particularly in younger age groups because all cervical cancer is caused by it and it can be treated as I outlined.

Your question was how often to test:

STD Testing Frequency Recommendations Mayo Clinic
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

Currently in the US testing is very erratic, and I've noticed that a lot of default panels for testing totally neglect Chlamydia and HPV.  That's unfortunate.

JeffEng16

JohnISmyname402 reads

They either don't have any routine recommendation or it's frequency unspecified for my category (man over 30 without any indication of illness) so I still don't know how often should I get tested. I know once a month may not be necessary and once a year may be too long. There's still lots of room in between. Assuming I don't engage in any high risk activity, I guess once a quarter, or may be two, should be sufficient and not be too excessive. I am sorry if I sound paranoid, but I believe if one is to engage in any high risk activities then one should take extra caution.

Posted By: JeffEng16


That quote you pasted left out HPV.  And if you're female, it should be mandatory that you test for it, particularly in younger age groups because all cervical cancer is caused by it and it can be treated as I outlined.

Your question was how often to test:

STD Testing Frequency Recommendations Mayo Clinic
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

Currently in the US testing is very erratic, and I've noticed that a lot of default panels for testing totally neglect Chlamydia and HPV.  That's unfortunate.

JeffEng16

JohnISmyName--

Make sure you read #3 and understand my point about the impact of a seronegativity window and it's influence on your testing timing.  Again, any MD who is a primary care physician who keeps up can impose this framework to give you good care and test timing tailored to your age and your risk factors.

You don't sound paranoid at all.  Not when you're talking about being sexually active and staying safe. You're simply asking an intelligent question that should be asked to stay medically safe and to help your partners stay medically safe.  You specified your age range, but not your specific practices. Again seeing an MD who keeps up with the STD guidelines and literature will get you into an SSTD testing pattern that is appropriate for you.

1) Actually if you read the small print there are specific recommendations but so much of this depends on precisely what your risk factors are.
2) Any primary care physician/or clinic who keeps up with  STDs can sit down with you and tailor your testing to keep you as safe as possible. Any infectious disease physician can sit down with  you and do the same.  If you see an M.D. for this, you can tailor testing that will work to protect you and your partners as well as testing can.  I don't know your locale, so I can't be specific as to what clinics are available, but I'm sure you can Google or Bing to locate them.
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

3) 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

***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.

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.

The porn film industry in California has yet to come to agreement with that state on mandatory condoms. In April, 1994 five people we know of died of HIV. This caused the state to quaranteen another 190 people for months until they could have several cycles of testing, and they didn't test them for every possible disease although they did cover HIV and Hepatitis A, B, C.  Actors who don't use condoms are at risk, and some have probably gotten and died from  HIV that few people know about.

I would put this in bold font if I could here:

***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.

Vaccines Available

There are vaccines for Hepatitis A and Hepatitis B.  Research is wide spread for a Hepatitis C Vaccine, but we aren't there yet.

For HPV, which is the cause of all cervical cancer, and I discussed it in detail on another thread, we have two HPV vaccines are licensed by the FDA and recommended by CDC. These vaccines are Cervarix (made by GlaxoSmithKline) and Gardasil (made by Merck).

Both vaccines are very effective against diseases caused by HPV types 16 and 18; HPV 16 and 18 cause most cervical cancers, as well as other HPV associated cancers.
Both vaccines have been shown to prevent cervical precancers in women.
Both vaccines are very safe.
Both vaccines are made with a very small part (in this case, the protein outer coat) of the human papillomavirus (HPV) that cannot cause infection.
Both vaccines are given as shots and require 3 doses.
Only one of the vaccines (Gardasil) protects against HPV types 6 and 11, the types that cause most genital warts in females and males.
Only one of the vaccines (Gardasil) has been tested and licensed for use in males.
While both vaccines protect against HPV16, which is the most common HPV type responsible for HPV associated cancers including cancers of cervix, vulva, vagina, penis, and anus and oropharynx, only one of the vaccines (Gardasil) has been tested and shown to protect against precancers of the vulva, vagina, and anus.

Again I want to stress the importance of getting to a competent MD, whatever the setting to get a testing MO that fits you.  I've given you a website that will ID clinics in your zip code.

I'm being about as specific I can.  I hope this helps.

Good luck,

JeffEng16

-- Modified on 6/10/2012 11:13:08 AM

JohnISmyname446 reads

Thank you so much for your help.

Posted By: perfectstorm
= HIV, Chlamydia, Gonorrhea, Syphilis, Herpes 1 and 2, and hepatitis B and C
Really Hep A and B are the ones to be tested for in an STD panel. Hep C is actually not considered an std. Unless a girl has her period or another disease that causes lesions (Herpes for instance), there is little to no risk of contracting Hep C through intercourse.

Luckily there are vaccines for A and B and I hope you all have them. :)

Kiss me,

Kate

Hi  Kate--

Actually with all due respect, you're wrong.  Hep C should be tested in any Hepatitis testing sisituation 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.

While Hepatitis C is primarily transmitted by blood, and I understand you might consider it semantics. but Hepatitis C transmission as an STD is ***growing***,precisely because Hepatitis C CAN BE transmitted by exposure to blood through unprotected sex.  Hepatitis C can also be transmitted by another body fluid, SEMEN. Hepatitis C transmission is very low in couples with long term monogomous sexual activity, but blood may be present because of genital sores, cuts or menstruation. Currently surveillance by CDC finds that Hepatitis C has been transmitted as an STD slightly above 10% in studies with an infected sex partner as the ONLY risk for infection, and research on this has intensified by infectious disease and hepatitis centers and GI departments in med schools and private GI labs in the past 5 years.

We all understand that it's a mantra for providers and clients, and anyone in a sexual situation who practices safe sex to use condoms during vaginal sex or ***not to have BBFS**.

In fact, and this is directly from the CDC web page on Hep C, especially among HIV-infected persons, "CDC surveillance data demonstrate that 10% of persons with acute HCV infection report contact with a known HCV-infected sex partner as their only risk for infection."

Right now, sexual transmission is being contexted as having moved from rare to uncommon but it's as high as 10% in current CDC surveillance.  If you talk to the docs at CDC who are in the STD sections or the Hepatitis sections they consider it "significant and growing." 10% is statistically very significant. The CDC has webpages titled "CDC--Hepatits C--STD Treatment Guidelines:

CDC Sexually Transmitted Disease Guidelines 2010 Hepatits C
http://www.cdc.gov/std/treatment/2010/hepc.htm

How Hepatitis C is Spread
http://www.avert.org/hepatitis.htm

Sexual Transmission of Hepatitis C
http://www.hcvadvocate.org/hepatitis/Basics/sextrans.pdf

Hepatitis C New York State Department of Health
http://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_c/fact_sheet.htm

FAQ About Sexual Transmission of Hepatitis C
http://www.hcvadvocate.org/hepatitis/factsheets_pdf/sexFAQ.pdf

This is taught in every medical school setting in NYC, NY state, and the US and has been for years.

I'm looking at a current Board Review for internal medicine residents and it is a point made with emphasis because sexual transmission of Hepatitis C is growing in the US and world wide

This point is also made among the questions on every subspecialty board certification exam for MDs that deals with primary care or infectious disease (family practice, internal medicine, OBGYN, dermatology, and infectious disease to name a few).

Mainstream medicine and every infectious disease reference, practitioner, CDC, WHO, med school, residency teaches Hep C can be an STD.  There isn't an infectious disease textbook or any literature on  Hep C that doesn't discuss it as a potential STD because it is. Every ID texbook in my library does this. Granted Hep C is not very efficiently transmitted through sex, but if blood and lesions are in the equation it sure can be. Hep C transmission through sex is possible, but rarer than transmission through needle sharing with drug injection or exposure to blood products in exposures in health-care settings as a consequence of inadequate infection-control practices. From the CDC's current web page on Hepatitis C transmission:

Best,

JeffEng16

Thanks for all of the info Jeff. I stand corrected on Hep C not being considered an STD.

Regardless, I do hope that everyone gets tested for all diseases- whether classified as an STD or not.

Stay safe and healthy everybody. :)

Kiss me,

Kate

Register Now!