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Testing for Sexually Transmitted Diseases


melrich

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STDs have become a hot topic over the last 10 years. Being in one relationship for a long time has meant I have not really had to think about the issue too much.

 

But I was intrigued by a post yesterday where a poster said they would wait 6 months before having sex so that they could have each other tested for STDs. The 6 months was to get over any latency period.

 

  • Is it common now to ask for testing?
  • How do you handle testing for something like genital herpes where blood test is unreliable and only certain tests are when lesions are in eveidence and can be swabbed?
  • Is it the same test for HIV, chlamydia, syphillis etc etc or is it a different test for each one?
  • Are the tests expensive?
  • Do you take them every time you meet a new potential sex partner?
  • How long do the tests take?
  • If you do both get testing, what is the process, do you sit down and show each other all the results of a clean billing or what?

I'm really interested in the practicallities of such an approach.

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Hey Melrich,

 

 

Great topic, and way overdue for discussion!

 

 

My understanding is that a 6 month incubation period between a person's last sexual encounter and any new unprotected encounter following being tested is the safest way to protect oneself from exposure, since some STI's incubate 4-6 months before testing positive (HIV being one).

 

Using protection with a new partner at least until that time is up and both partners can be tested is recommended for safe sexual practice. Being with a long term monogamous partner who has been tested decreases that risk even further.

 

There are new HSV blood tests out now that can differentiate between HSV1 and HSV2- and they should be requested.

 

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Depending on where you are, there are Planned Parenthood clinics in the US that will do the STI testing for a sliding scale fee or some for free- and they will do anonymous testing for teens as necessary.

 

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I have also gone myself to an "HIV Testing Clinic" day at my local hospital where they did free anonymous HIV testing. You were assigned a number and returned 2 weeks later for your results, given based on your number. There were HIV counselors on hand should anyone come up positive.

 

A woman can request such tests through her gynocologist as well- and if she has insurance they can be covered by her insurance.

 

Or depending on where you are, a Google search of STI testing clinics in your area may turn up clinics nearby.

 

For example, here is an STI clinic in London, UK:

 

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Here's one in S. Australia:

 

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This day and age I do think it's practical to sit down with a partner and discuss the risks involved with having unprotected sex. If a person has a known STI that should be shared with a partner before intimate contact sot that methods of protection can be discussed, or if that partner is willing to take the risk involved with having intercourse with an infected person, since condoms decrease the risk considerably, but do not prevent it 100%.

 

If a person is unsure about their status in terms of STI's, it is advisable that they go together with their partner to be tested and given a clean bill of health before engaging in risky sexual practices such as unprotected sex.

 

The CDC has a great website with lots of information about STI's, transmission, testing and treatment, and is definitley worth a look.

 

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It would seem to me that if a couple are comfortable enough having sex with one another they should be comfortable enough to talk about the risks of STI's and how to protect themselves and each other from infection.

 

Again, great topic!

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-yes it is VERY common to ask for tesing, when I go, I go specifically for the test, Im in good health otherwise.

 

-you cant be tested for HPV or herpes, you only know you have them when you get abnormal cells or warts... there can be years between contracting hte virus nad getting symptoms

 

-same test for everything purely genital (chlamydia, the clap, etc) which is swabs and pee... but then hep and aids and blood diseases have to be done at a diagnositc centre... NEEDLES

 

-they are free till you are 23 here, then they are $20 at the family planning centre

 

-You should take them everytime you meet a new partner

 

-not long, you talk a bit, then the swabs are done, then your over. they dont do blood tests as routine here, seeing as there is such a small chance of blood disease in this country.

 

-you dont get paper here, you get a phone call and go in for treatment if you have something... you just tell eachother whats going on... if you trust eachother

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After I found out my x cheated I immediately made a Dr's appt. Despite the fact that he told me "not to worry, she don't have anything"

 

I had only slept with 2 partners during my lifetime and I didn't want to worry about infections/diseases for the remaining years I had left of my life.

 

A blood test and cervical swab test is all that was needed.

Cost was covered by insurance BUT i made him foot the remainder of the expenses -and he did!!

 

Tests results were available within 10 days

 

I'm still single and guess that most partners would feel reasurred to hear that the other partner had been tested before embarking on a new sexual relationship. I know I would!

 

BTW... Tests were negative

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STDs have become a hot topic over the last 10 years. Being in one relationship for a long time has meant I have not really had to think about the issue too much.

 

But I was intrigued by a post yesterday where a poster said they would wait 6 months before having sex so that they could have each other tested for STDs. The 6 months was to get over any latency period.

 

 

for most HIV tests now it's 3 months, so for me barrier protection for at least 3 months, then test, then decide together whether or not to continue barrier protection. Actually only been in the situation once (with current boyfriend) and discontinued barrier protection after both testing negative for everything

  • Is it common now to ask for testing?

It is in my circle of friends, but we're all well-educated 20-somethings. I'm sure it varies between demographic groups

  • How do you handle testing for something like genital herpes where blood test is unreliable and only certain tests are when lesions are in eveidence and can be swabbed?

Well, again, only been in the testing situation with my boyfriend: he had a fairly tame past (as did I) and hadn't had sex in quite a while so I assumed that if he had herpes or genital warts it/they would have showed up before then. You're never 100% risk-free, we just took the chance

  • Is it the same test for HIV, chlamydia, syphillis etc etc or is it a different test for each one?

HIV and hepatitis: blood test. Rest: swab

  • Are the tests expensive?

I'm sure it varies hugely per country. They were covered by my medical insurance here in The Netherlands.

  • Do you take them every time you meet a new potential sex partner?

It hasn't come up, but I would

  • How long do the tests take?

Well, there's the drawing of blood & a swab which takes no time at all, the a 1-2 week wait for results in most places.

  • If you do both get testing, what is the process, do you sit down and show each other all the results of a clean billing or what?

Your doctor phones you with the results here. You get the paper as well, but we took each other's word for the phone-news being good.

 

But yeah, I speak only for myself!

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Some practical clinical information:

 

Common STI's diagnosed by drawing a blood sample:

 

HIV

Herpes/HSV(unless active lesions are present)

Syphilis

Hepatitis B, C

 

Common STI's diagnosed by vaginal swabs read on a slide:

 

Bacterial vaginosis

Trichomoniasis

HPV

Gonorrhea (culture)

Chlamydia- either by exam or screening of swabbed cells

Trichamoniasis

 

Multiple swabs may be taken as the preperation for each test may differ slightly.

 

STI's diagnosed by other methods:

 

Scabies/Crabs/Pubic Lice: visual examination of pubic hair and possible skin scaping with microscopic analysis

 

Molluscum Contagiosum: visual examination or microscopic examination of fluid or tissue samples

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There are new HSV blood tests out now that can differentiate between HSV1 and HSV2- and they should be requested.

 

My research says these tests are still very unreliable (high rate of false negatives). I guess it is a case of being as careful as you can be without any guarrantees.

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I got tested for Herpes recently (negative thankfully) it cost $160 at Planned Parenthood. Test took about 10 minutes (1.5 hour wait YAY!). It was the first time I was tested, but from now on I will get tested before sexual encounters (also a way of calming myself down/self control)... I swear I've never panicked more in my life when I thought I had herpes... just turned out to be abrasions.

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When I started sleeping with my (now) husband I insisted on condoms. I was also on the Pill, so the condoms were about disease first and foremost. We were clicking really well and the condoms weren't suiting us, so I suggested we both get tested and we could stop using the condoms. He was fine with that and we both were tested straight away.

 

I think Hope has already covered the medical side - as I remember it my blood was tested for a few different things, so it was one session of a few vials of blood taken, were they were then taken to pathology somewhere and put through a gamut of tests. I did it through the local GP (one in the city, Collins St) that has a pathology lab next door. Results then mailed out within a day or so. I think it was bulk billed - I just paid for the doctor's consult.

 

The other stuff you can't test for just had to be a matter of trust, like the 3-6 months' HIV waiting period.

 

I have to say, I have not asked for tests from a partner before, but then again, it was a while between serious relationships and no use of condoms.

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My research says these tests are still very unreliable (high rate of false negatives). I guess it is a case of being as careful as you can be without any guarrantees.

 

It is true that historically HSV1 & HSV2 has been difficult to differentiate, but as evidenced by this article (and has been approved by the FDA) the tests available for differentiating are becoming more accurate and type specific.

 

How can you tell a 'type-specific' blood test from one that isn't type-specific?

 

Many of the herpes antibody tests available from health care providers are flawed: they do not accurately distinguish between HSV-1 and HSV-2. In fact, some of these tests will give a positive result for HSV-2 even when you have antibodies to only HSV-1. Others cannot detect HSV-2 antibodies when HSV-1 antibodies are also present. New tests are now available that are accurate. It is important to be sure that the laboratory your doctor uses is utilizing the best tests.

The new tests detect antibodies to a protein that differs between HSV-1 and HSV-2. This protein is glycoprotein G (or "gG") and the tests are sometimes referred to as the glycoprotein G specific or "gG-based" tests. Another test is the Western blot test. It also is very accurate. In fact, it is the test that most of the gG-based tests have been compared with to determine their accuracy. The Centers for Disease Control now recommend clinicians avoid blood tests that are not type specific. The best way to tell that a test is type-specific is to ask if it is based on glycoprotein G or to ask for one of the tests named in the next section.

Tests to Use

HerpeSelect® HSV-1 and HSV-2 ELISA Focus Technologies (Cypress, CA) makes and sells this test kit in the United States and many countries around the world. This test has been approved by the FDA for diagnosing HSV infection in adults, including pregnant women. The test takes less than a day once the specimen arrives in the laboratory. Many health care providers send blood specimens to local laboratories who then send specimens on to reference labs.

HerpSelect® immunoblot. This test is also produced by Focus and contains the same recombinant gG-1 and gG-2 that is used in the HerpeSelect ELISA kits. This test is also FDA approved but is used in smaller labs and some clinics. It detects antibodies to both HSV-1 and HSV-2 on a paper strip and is more expensive than the ELISAs. More can be learned about all of the HerpeSelect® tests at the link removed.

Western blot. The other test available is the University of Washington's Western blot test. This test is is very accurate but is more expensive than the others and takes longer to perform. This test is not widely available and is not FDA approved. It is used as a reference test. However, it may be worth it to have your serum sent for Western blot if the HerpeSelect test result is indeterminate (not definitively positive or negative) or very low positive. Some local and reference labs will send specimens on to the UW Virology Lab for Western blot. Or, your provider may choose to send your serum directly.

biokit HSV-2 is the new name given to the test that was sold previously as "POCkit™HSV-2." The test is being offered by Biokit USA as biokit-HSV-2 and by Fisher Scientific under the brand name "SureVue." Thus, biokit HSV-2 and SureVue HSV-2 are the same test. This test can be performed in offices and clinics that have laboratory facilities. Only a couple drops of blood from a finger-stick is needed. This test requires about 10 minutes to perform and read.

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-you cant be tested for HPV or herpes, you only know you have them when you get abnormal cells or warts... there can be years between contracting hte virus nad getting symptoms

 

actually, you can be tested for the HPV virus with a swab test in the US, it is very sensitive. but it's not automatically given. you just have to ask for it.

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actually, you can be tested for the HPV virus with a swab test in the US, it is very sensitive. but it's not automatically given. you just have to ask for it.

 

My gyn tests for HPV each year with my normal pap smear. I wonder if it just depends on where you go?

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Well that was me, I thinkk.

 

Common? I've had few partners but from what I can tell it is not "that" common"

Herpes - never had to deal with that in myself or a partner so I don't really know.

HIV, chlamydia and syphillis each is a different test I think.

The tests are not always free but for women, the annual pap can inlcude the chlamydia test and the annual physical can include STDs (I am in the USA). The self-test for HIV is about $65 us I think (been a few years)

Test results can take a week or so I guess - it depends

 

I have only gone through the testing process when it's clear we're going to be sexual - and it's not usually clear for me until at least a few months into the relationship, and never before we're exclusive, so the conversation was comfortable the majority of the time. There was only one man I thought of sleeping with who refused to get tested for HIV (I said I would too, although I was sure I was HIV-free - no need to explain why here). I would not have sex with him. I do not have sex - even with a condom - pre-testing.

 

As far as results - in one case I offered my results but more as a joke - we knew each other very well, loved each other and I would have never needed to ask for the results (we both saw our doctors within the same few weeks-period of time). In one case he gave me the 800 number, and his code, to call for his results. I did call - perhaps that was a sign I didn't trust him enough.

 

It was never a "serious sit down" where we exchanged results. I will add that it does require a level of trust - that your partner has not been with anyone else the last six months. Because of who I chose to be intimate with (and the small number of people) that wasn't a real concern for me.

 

I should add that testing doesn't necesarily mean we stop using condoms.

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