In most cases it is impossible to tell if an STD is present without clinical evaluation.
The more sexual partners you have, the greater your chance of exposure to HIV or other STD. It is always difficult to know whether a person is infected or has had sex with people who are infected. Sometimes, early in the infection, there may be no symptoms, or the symptoms may easily be confused with other illnesses.
At FamilyCare of Kent, we use the most sensitive tests available for clinical testing. Our complete STD screening consists of the following:
- Directed physical examination looking for evidence of infection. This includes oral and genital examinations. When looking for human papilloma virus (also known as HPV, genital warts, or condyloma acuminata) we frequently use magnification and may apply acetic acid (vinegar) to better identify genital warts caused by HPV (clinical exam)
- HIV (AIDS) testing using western blot technology with confirmation of all positives (blood test)
- Syphilis (blood test)
- Chlamydia (cervical, oral, anal, and/or urine sample depending on circumstances)
- Gonorrhea (cervical, oral, anal, and/or urine sample depending on circumstances)
- Herpes, both type 2 genital herpes and type 1 nongenital herpes image (blood test and/or culture)
- Human papilloma virus (HPV,) also known as genital warts or condyloma acuminata image (clinical exam with high risk cervical DNA testing for women 30 and older)
- Pelvic inflammatory disease (cultures and clinical exam)
- Trichomoniasis (DNA hybridization assay, women only)
- Bacterial vaginosis* (DNA hybridization assay, women only)
- Yeast vaginosis* (DNA hybridization assay, women only)
- Molluscum contagiosum (clinical exam)
- Hepatitis B and C (blood test done if never immunized against Hepatitis B)
- Lice and scabies (clinical exam)
- Granuloma inguinale (clinical exam with additional confirmatory testing required if disease is suspected)
- Lymphogranuloma venereum (clinical exam with additional confirmatory testing required if disease is suspected)
- Chancroid (clinical exam with additional confirmatory testing required if disease is suspected)
*Not currently considered a sexually transmitted infection
For women, if you are due for your Pap smear, we can obtain that at the same time we do your STD testing.
Listen to Molly’s story about having herpes (CDC podcast).
To reduce your chances of being infected with AIDS or other STDs, you should always use a condom from start to finish. While this is not 100% effective, it does significantly reduce risk.
In monogamous relationships, both partners should have STD testing prior to any sexual activity. In multiple partner situations, anyone joining the relationship should have STD testing done before any sexual activity with current partners. Periodic STD testing should be done every 1 to 12 months depending on a variety of factors. Talk with your nurse practitioner to determine the best schedule for you.
Individuals who engage in sexual activity as a source of income should have at least monthly STD testing. Prevention is critical. It is much easier to prevent sexually transmitted diseases than to treat them after the fact.
Immunization against HPV (the cervical cancer vaccine) is strongly recommended for all prior to sexual activity or as soon as possible after the start of sexual activity of any sort. Gardasil® provides protection against HPV types 6, 11, 16, and 18. Cervarix® protects against HPV types 16 and 18. Both are indicated for use from ages 9 to 26 years old. There is a patient assistance program available for Gardasil, and our staff will work with eligible patients to help in the application process. Both males and females can get the HPV vaccine.
For both males and females, HPV type 16 has been shown to cause cancer in other areas, including the mouth and throat. HPV vaccine can be given to males just like it is given to females. More research is needed to see if protection is provided against throat and other cancers.
AIDS/HIV: (treatable) Requires multiple medications on a daily basis and care by a specialty team.
Listen to Ida’s story about having HIV (CDC podcast).
Bacterial vaginosis: (curable) Typically a course of treatment with a specific antibiotic will cure this infection.
Chancroid: (curable) Typically a course of treatment with a specific antibiotic will cure this infection.
Chlamydia: (curable) Typically a single dose of a specific antibiotic taken once will cure this infection. A test of cure is recommended 8-12 weeks after treatment. All sexual partners you have had contact with in the past 6 months should also be treated.
Gonorrhea: (curable) Typically a single dose of a specific antibiotic taken once will cure this infection. A test of cure is recommended 8-12 weeks after treatment. All sexual partners you have had contact with in the past 6 months should also be treated. Anyone treated for gonorrhea should also be treated for chlamydia.
Granuloma inguinale: (curable) Antibiotic treatment for several weeks.
Hepatitis B: (vaccine preventable) Acute illness usually goes away without treatment. Chronic infection requires long-term treatment by specialist with medication.
Hepatitis C: (curable) Long -term treatment by specialist with medication
Herpes: (treatable) There are 2 types of herpes, type 1, which causes 15% of genital herpes cases, and type 2, which causes 85% of genital herpes. If you have an outbreak, both types of herpes can be treated. If you have frequent outbreaks, there is medication for both types of herpes to prevent outbreaks.
If you have type 2 herpes and your partner does not, then you can take a daily antiviral medication to reduce the risk of your partner getting infected. If both of you have tested positive for herpes type 2, then there is no need to treat one partner to reduce the risk of spreading herpes. If you have herpes type 2 you are unlikely to get infected with herpes type 1; however having herpes type 1 will not protect you from becoming infected with herpes type 2.
Human papilloma virus also known as HPV, genital warts or condyloma acuminata: (treatable) While treatable, this very common infection is frequently self-limiting and may resolve on its own within 2 years. Treatment options vary, but a combination of freezing of the warts, followed by treatment with a cream applied to the area, is most commonly used in our practice. We apply an anesthesic cream to the infected area first to minimize the discomfort of freezing.
Lice and scabies: (curable) Typically a short course of treatment will cure these infections.
Lymphogranuloma venereum: (curable) Antibiotic treatment for several weeks
Molluscum contagiosum: (curable) Treated by freezing, removal, or with medication
Pelvic inflammatory disease: (curable) Typically a course of treatment with multiple antibiotics will cure this infection. Partner testing is strongly recommended as well.
Syphilis: (curable in early stages) Typically a course of treatment with a specific antibiotic will cure this infection. Partner testing is strongly recommended with a repeat test for partners 3 months after last exposure or diagnosis of partner.
Trichomoniasis: (curable) Typically a course of treatment with a specific antibiotic will cure this infection.
Yeast vaginosis: (curable) Typically a course of treatment with a specific antifungal agent will cure this infection.
What is Pre-Exposure Prophylaxis (PrEP)?
PrEP refers to Truvada (tenofovir/emtricitabine), a single tablet that is taken by HIV-negative persons to prevent HIV.
Large research studies show that in addition to using condoms, taking Truvada can help prevent HIV infection when taken by people who are at high risk of getting HIV from sexual activity. Men who have sex with men, or heterosexuals who have an HIV-positive partner are people who may be at high risk.
Truvada is approved by the FDA to be taken once every day. It can be taken every morning or every night, with or without food. It is not approved to take less often than daily. It is not approved to take as a morning-after pill.
Truvada can reduce the risk of HIV infection by up to 90% if it is taken every day and condoms are used, too.
Truvada does not prevent STDs and does not prevent Hepatitis B or C.
Truvada is only available by prescription. If you and your nurse practitioner decide Truvada is a good idea for you, then your nurse practitioner will:
- test to see if you are already infected with HIV or hepatitis B -check for STDs
- check your kidneys
- talk to you about your sexual practices and condom use
- talk about becoming pregnant while taking Truvada
- expect to see you in the clinic every three months for follow-up
The most common side effects of Truvada are headache, nausea and skin changes. In some people, Truvada has damaged the kidneys or liver or caused bone thinning.
If you start Truvada, you need to tell your nurse practitioner if you:
- have problems taking Truvada every day
- have problems using condoms consistently
- have side effects
- have symptoms of an STD
- have symptoms of acute HIV (sore throat, swollen glands, rash, diarrhea, or flu)
Your nurse practitioner will want to check you regularly for:
- HIV or other STD
- kidney damage
- ability to take Truvada every day
If you become infected with HIV then you cannot take only Truvada. People with HIV take Truvada as part of their cocktail of meds for HIV.
Washington state has a program called PrEP-DAP that covers the cost of Truvada. It does not cover the cost of lab tests or office visits. You can read more about PrEP and print out a PrEP-DAP application here.