Sexually transmitted infections (STIs)

Diagnosis

Testing for sexually transmitted diseases (STDs) is an essential part of maintaining sexual health. The overview of the standard procedure for STD testing is as follows:

• Consultation with a healthcare provider: The first step involves discussing any signs and symptoms with a healthcare provider. Based on this discussion, they may recommend one or more specific tests to determine the presence of an STD.
• Physical examination: The provider may perform a physical exam, including a pelvic exam, to look for signs of infection like rashes, warts, or discharge.
• Laboratory testing: Lab tests help diagnose STDs, even when symptoms are not present. These tests include:
  • Blood tests: Used to diagnose diseases like HIV and syphilis.
  • Urine samples: Can detect several other STDs.
  • Fluid samples: Samples from genital sores are analyzed to identify specific infections.
• Screening tests: Screening refers to testing for an STD in an asymptomatic individual. This is not typically a standard procedure but may be recommended based on an individual’s risk factors, such as new sexual partners or a history of STDs.

The guidelines for who should get tested and when include:

• General population (ages 15-65): Screen for HIV at least once.
• Pregnant women: Screen for syphilis, hepatitis B, chlamydia, and HIV early in pregnancy, with additional tests for high-risk individuals.
• Women aged 21 and older: Regular Pap tests are recommended to check for cervical abnormalities that could be caused by HPV.
• Sexually active women under 25: Advised to test for chlamydia and gonorrhea.
• Men who have sex with men: Should undergo regular screenings for STDs including gonorrhea, syphilis, chlamydia, and HIV.
• Individuals with HIV: Recommended to get tested for additional STDs like gonorrhea, chlamydia, herpes, and syphilis soon after diagnosis.

Additionally, it’s important for new partners to consider testing before engaging in sexual activities and to be aware that a recent infection might not immediately show up on tests.

Treatment

Treatment will depend on the causes, there are multiple methods for treating STDs. Treatment for bacterially-induced sexually transmitted diseases is typically less complicated. Viral STI infections are not always curable but they can sometimes be controlled and treated.

Pregnant women who receive treatment as soon as possible can either eliminate or significantly reduce the chance that your unborn child will contract the STD.

Treatment for STDs typically includes one of the following, based on the type of infection:

• Antibiotics: Several sexually transmitted diseases are caused by bacteria or parasites, including gonorrhea, syphilis, chlamydia, and trichomoniasis, can be treated with antibiotics, frequently in a single dose.
  Once you begin treatment with antibiotics, you must take the medication as prescribed. Inform your healthcare provider if you don’t think you’ll be able to take the medication as prescribed. There might be a simpler, shorter treatment plan available.
  It’s also important that you avoid having intercourse for seven days after finishing your antibiotic course and recovering from any sores.
  Because there is a substantial risk of reinfection, healthcare providers advise retesting individuals with chlamydia every three months following treatment.
• Antiviral drugs: Your healthcare provider may prescribe an antiviral medication if you have HIV or herpes, which prevents the virus from spreading.
  If you combine a prescription antiviral medication with what is known as daily suppressive therapy, you should experience a reduction in herpes recurrences. However, you can still infect your partner with herpes.
  Antiviral medications have the long-term ability to suppress HIV infection. Even if there is less chance of infection, you can still share the virus and carry it.
  HIV treatment is more effective the earlier you begin. It is possible to reduce the viral load in the blood to the point where it is undetectable if you take your medications as prescribed. You won’t infect your sexual partners with the virus at that point.
  If you have ever had an STD, find out from your healthcare provider how long it is until you need another test after treatment. Retesting will confirm whether the treatment was effective and prevent you from contracting the infection again.
• Informing your partner: If your STD test results come back positive, it’s essential to inform your sexual partners. Notify your current partners as well as anyone you’ve been intimate with in the past three months to a year that you are infected. They should undergo testing to ensure their health and prevent further transmission of the virus. While notifying partners can be emotionally challenging, it’s crucial for their well-being and to halt the spread of the infection.