Quick sheet: How often you should get tested for STIs and STDs

If you’re sexually active, you know you need to get tested for STIs, but how do you know when it’s time? Do not wait until you experience symptoms to get checked — many STIs show zero symptoms or can lay dormant for a long time, and some untreated STDs can lead to complications like infertility, chronic pain, or cancer. 

How often should you get screened? It depends on your age, gender, number of partners (and other risk factors)

Unfortunately, there is still stigma surrounding STI diagnoses, which is one of the contributing factors to their significant increase in recent years. In 2015, The Centers for Disease Control and Prevention (CDC) reported approximately 20 million new infections per year for people 15 to 25 years old. They also found that syphilis, chlamydia, and gonorrhea are growing resistant to antibiotics. That means it is more important than ever to get regular STI screenings. But how regular is regular? It depends on your age, gender, number of partners, and other risk factors. Whatever your situation, we’ve got you covered with a quick guide to scheduling STI testing.

If you’re engaging in any sexual activity, you should be getting tested

First, a little terminology lesson. We are talking about STIs (sexually transmitted infections) —some are asymptomatic, many are curable, and virtually all are treatable. Not all STIs turn into STDs (sexually transmitted diseases). Basically, you can get infected, but not have symptoms or develop the disease. Also, when referring to a “sexually transmitted” infection, I mean an infection spread through oral, anal, and vaginal sex, as well as sharing sex toys and skin-to-skin genital contact (in the case of HPV and herpes). If you are engaging in any of these activities that can result in transmission — even if you are using protection — you should be getting tested.

FYI: Only people with vaginas can be tested for HPV 

Routine STI testing usually includes chlamydia, gonorrhea, HIV, syphilis, and hepatitis, with genital herpes and the parasite trichomoniasis only tested for if you come in with symptoms and HPV tested for during a routine pap smear for people with vaginas (there’s no screening test for people with penises). If you are concerned about an STI that is not routinely tested, make sure to ask to be tested for it. It is important to be honest with the person administering your test about your STI history, number of partners, the kind of sex you’ve had (oral, anal, vaginal), how often you use barrier protection such as condoms and dental dams, and other activities that may put you at risk for certain infections, such as sharing needles. This will help them determine which STI tests make the most sense for you and how often you should be tested.

Get tested at least once a year, post unprotected sex, in between new partners, and if your partner has sex with someone else 

While the CDC’s guidelines differ based on demographics, they generally recommend getting tested at least once a year, plus after unprotected sex, in between new partners, and if your partner has sex with someone else. If your partner has an STI, it does not necessarily mean you will get it too, but you are at risk for being infected. If you have symptoms concerning a possible STI — itching, burning, pain, sores, or abnormal discharge, bleeding, or odor — see a doctor right away. If you are asymptomatic, the following is a guide for if and when you should get screened for every major STI.

If you are a person with a vagina under 25:

Get tested once a year. If you have multiple partners, or your partner has multiple partners, get tested every three to six months.

Starting at age 21, pap smears are recommended every three years. If you test positive for certain strains of HPV — those known to be associated with cervical cancer — your doctor may recommend more frequent pap smears for a period of time. The HPV vaccine is recommended through age 26. 

If you are a person with a vagina age 25 or older AND you have unprotected sex, a new partner, or multiple partners:

Get tested once a year. If you have multiple partners, or your partner has multiple partners, get tested every three to six months.

Starting at age 21, pap smears are recommended every three years. If you test positive for certain strains of HPV — those known to be associated with cervical cancer — your doctor may recommend more frequent pap smears for a period of time. The HPV vaccine is recommended through age 26. From ages 30 to 65, it is recommended that you get a pap smear and HIV test every five years OR just a pap smear every three years.

If you are a person with a penis who has sex with people with penises:

Get tested once a year. If you have multiple partners, or your partner has multiple partners, get tested every three to six months.

The HPV vaccine is recommended through age 26.

Hepatitis A and B vaccines are recommended.

If you are a person with a penis who has sex with people with vaginas:

Get tested once a year. If you have multiple partners, or your partner has multiple partners, get tested every three to six months.

The HPV vaccine is recommended through age 21.

If you are trans:

Unfortunately, the CDC does not offer concrete screening guidelines for trans folks. However, it is possible to assess your risk by considering your genital anatomy, your partner’s genital anatomy, number of partners, sexual behaviors, and other risk factors. If you have received gender confirmation surgery, your recommendations may be even more specialized. It is a safe bet to get tested once a year, and if you have multiple partners, or your partner has multiple partners, get tested every three to six months.

If you are having receptive anal sex or have multiple partners with a penis, follow the guidelines for people with penises who have sex with people with penises.

The HPV vaccine is recommended through age 26. If you are a trans woman who has received gender confirmation surgery, talk to you doctor for specific HPV guidelines based on your anatomy. 

If you are pregnant:

Get tested for chlamydia, HIV, syphilis, and hepatitis B during your first prenatal visit. Get tested for gonorrhea and hepatitis C if you are at high risk.

If you are a sex worker:

Get tested once a month.

If you have previously tested positive for an STI:

Your doctor will help you figure out a treatment plan, but you should also get tested six months after originally testing positive.

Image source: Tony Futura