Sexually transmitted infections

Catdoor

There seems to be an awful lot of unprotected sex going on. Recurring lapses in judgment. That little voice that says “wear a condom” was silenced by what? Alcohol (the usual suspect). The heat of the moment. Sometimes just embarrassment.

An irksome patient: Uses withdrawal as her form of birth control and comes to my office desperate for STI screening. Both situations could be remedied by using condoms. I tell her, first and foremost: USE A CONDOM (in this voice, too). IT’S IMPORTANT. Then the questions start.

What’s the difference between sexually transmitted infections (STIs) and sexually transmitted diseases (STDs)? They are the same thing. The terms are used interchangeably, but everyone is slowly transitioning to STIs. Disease implies a symptomatic and easily identifiable medical disorder, but the majority of STI are asymptomatic. And all STIs are infectious (they are transmitted through contact), so using the term “infections” instead of “disease” is more accurate.

What infections should I be screened for?
It depends on your age and medical conditions and sexual encounters. The most common STIs we screen for are Chlamydia, Gonorrhea, Trichomonas, Hepatits B and Hepatits C, HIV, Syphilis, Herpes, and HPV.

How long should I wait after unprotected sex to get tested?
I find the below list helpful (copied from ashasexualhealth.org). I think anywhere from 2 to 6 weeks after potential exposure is a good amount of time. It’s probably a good idea to refrain from intercourse (especially unprotected!) during that time. You don’t want to make this phone call: “I have chlamydia. I know I got it from someone else because I had sex with you yesterday but I was tested 3 days ago so it must have been the guy before you ….”

  • Chlamydia Urine Test: 
    • Possible Detection – Within the first week
    • Most Likely Detection – 2 Weeks
    • Highest Accuracy – 4 Weeks
  • Gonorrhea Urine Test:
    • Possible Detection – Within the first week
    • Most Likely Detection – 1-2 Weeks
    • Highest Accuracy – 2-3 Weeks
  • Herpes Simplex 1 & 2 Blood Test:
    • Possible Detection – 2-4 Weeks
    • Most Likely Detection – 6-12 Weeks
    • Highest Accuracy – 12-16 Weeks
  • Syphilis Blood Test:
    • Possible Detection – 1-2 Weeks
    • Most Likely Detection – 6 Weeks
    • Highest Accuracy – 12 Weeks
  • HIV Antibody Test :
    • Possible Detection – 3 Weeks
    • Most Likely Detection – 4-6 Weeks
    • Highest Accuracy – 12 Weeks
  • Hepatitis A Blood Test:
    • Possible Detection – 2-3 Weeks
    • Most Likely Detection – 3-6 Week
    • Highest Accuracy – 6-7 Weeks
  • Hepatitis B Blood Test:
    • Possible Detection – 1-6 Weeks
    • Most Likely Detection – 6-10 Week
    • Highest Accuracy – 12 Weeks
  • Hepatitis C Blood Test:
    • Possible Detection –  4-5 Weeks
    • Most Likely Detection – 6-9 Weeks
    • Highest Accuracy – 10-12 Weeks

How am I tested?
If you really read the list above you’d know the answer – urine and blood tests. Most patients who go to a gynecologist get an exam first, to check for obvious lesions (like herpes outbreaks) or pelvic inflammatory disease.

What do I do if it’s positive?
Many of these infections (the bacterial or parasite ones) go away with antibiotics – Chlamydia, Gonorrhea, Trichomonas, Syphilis. The viral infections – Herpes, HPV, Hepatitis, HIV – never really go away. There are meds to alleviate your symptoms or stop the virus from replicating uncontrollably. If you’re positive for one STI, you should be screened for all of them.

When can I have sex again?
If everything comes back negative, whenever you want (BUT USE A CONDOM!). If you need to take antibiotics, it’s safe to have sex 7 days after you finish the antibiotics.

 

There is a wealth of information out there about STIs. Here are some reliable websites (and my sources):
ASHAsexualhealth.org
CSC.gov/STD
PlannedParenthood.org

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