Dolly Doctor

Should I get an STI test?

STI tests needn't be as scary as you think... If you're due for a check up don't put it off. Here's why.

Dear DOLLY,

What does an STI check involve? What STI's should I be tested for?

Tamara An STI check can involve a few different things, depending on what is recommended. It is unnecessary and also illogical to have a 'test for everything' because there isn't actually a test for every STI under the sun! So the doctor or nurse need to talk to you briefly about your sexual history to see what the most useful tests will be.

A Chlamydia test is definitely recommended if you're sexually active. This can be done with a urine test - you pass the first bit of urine into a sterile jar. This might be all you need. And it definitely doesn’t hurt! You don't need to have a Pap smear before you turn 18, but it is a good idea to have a Chlamydia test every year no matter how old you are, if you've had sex. If the timing is right, then yes, it's very easy to do both tests at the same time.

Some young people will be advised to also have a test for gonorrhoea, this infection is more common among Aboriginal people and men who have sex with other men, so if you are, or have had sexual contact with, someone from either of these groups then this would be advisable. This can also be done on a urine sample like the Chlamydia test. Both Chlamydia and gonorrhoea can also be tested for using a swab from the cervix, which involves the same speculum procedure as the Pap smear.

If you have symptoms, like a vaginal discharge, pain or itch, then an STI check should ideally involve an examination - the doctor or nurse looks at your genitals on the outside and also inside using a speculum. The pubic and genital areas would be examined to look for any signs of pubic lice, herpes or genital warts. If any ulcers are seen, a swab for herpes would be taken from the ulcer. However if herpes ulcers and genital warts are not visible, there isn't a test that will easily tell you whether you have those infections. A swab from the vagina would then be taken to test for infections such as thrush (not sexually transmitted) and trichomonas. Examination and swabs in the genital area can be slightly uncomfortable, especially if you do have inflammation from an infection, but again, the doctor or nurse need to be extremely gentle and check with you that you are comfortable enough before proceeding.

If you are pregnant, then additional STI tests (apart from the above) include blood tests for HIV and syphilis. These infections are uncommon in young women generally in Australia, but really important to test for during pregnancy because of the effect on the baby. Blood tests do hurt a bit, but some people don't mind them at all and you've probably had at least one in your life before!?

It does sound complicated but it's important to talk to your doctor or nurse - remember it is confidential. For most sexually active young women, only a Chlamydia test will be recommended. Although you can ask to be tested for other STIs, it doesn't make sense to if they're not necessary. In fact, the results can be misleading. The most common STIs are Chlamydia, herpes and human papillomavirus (HPV, which causes genital warts or infection of the cervix that can lead to cervical cancer). Only Chlamydia can be easily tested for, and Pap smears can prevent cancer by picking up changes early. There is now a vaccine against some strains of HPV too, so if you haven’t had one, talk to your doctor about that.