I have never called someone and told them they had a sexually transmitted disease and heard the response “Oh I know. I figured that I had that.” With the rare exception of someone who’s partner was diagnosed and who presents for testing as a result, most of my ladies do not feel symptoms or have any indication that would lead them to expect a test to be positive.
Per the Center for Disease Control, “Total combined cases of chlamydia, gonorrhea, and syphilis reported in 2015 reached the highest number ever.”
Some ladies routinely decline STD testing. I offer testing to everyone every year. Married, single, engaged, it doesn’t matter. I am going to offer testing. I think people are sometimes afraid to test, and other times believe it is a disrespectful move that indicates distrust of their partner.
“STD positivity does not always equal infidelity.”
I know a man who found out years into marriage that his wife had HIV. She wasn’t cheating, she just hadn’t been tested in a decade. She found out incidentally in blood tests during a physical. They are still married, by the way. That’s LOVE. There are ladies who are more at risk than others, like anyone with a new sexual partner. These are the ladies who sound like nails on a chalkboard to me if they decline testing. Even if a partner says he has been tested, do you know when this testing was done relative to his most recent sexual encounter, and for what he was tested? There is not a universal “STD test”. Specific things have to be checked. Here are some basic fun STD facts.
- Gonorrhea/Chlamydia. According to the CDC 2015 stats (2016 is not reported yet) “Americans ages 15 to 24 years old accounted for nearly two-thirds of chlamydia diagnoses and half of gonorrhea diagnoses”.
- Trichomoniasis: “Most women found to have trichomoniasis (85%) reported no symptoms… Prevalence of trichomoniasis increases with age and lifetime number of sexual partners…”
- HIV: “If we look at HIV diagnoses by race and ethnicity, we see that African Americans are most affected by HIV. In 2015, African Americans made up only 13%* of the US population but had 45% of all new HIV diagnoses. Additionally, Hispanic/Latinos are also strongly affected. They made up 18% of the US population but had 24% of all new HIV diagnoses.”
- Syphillis: “Women’s rate of syphilis diagnosis increased by more than 27 percent from 2014 to 2015” (CDC).
- Herpes: “Herpes simplex virus (HSV) is among the most prevalent of sexually transmitted infections”. Blood testing for HSV 2 is reportedly as common as 15% to 52% of women, depending on their ethnicity. Evidence of disease is not always directly correlated with positive blood testing. This one is complicated to diagnose, but honestly it is one of the most benign STDs from a danger-to-your-body standpoint.
Testing is not automatic. Patients often tell me, “Oh wouldn’t my Internist have done testing?” I tell them no, “not unless you asked or they specifically offered.” Also keep in mind that if a partner doesn’t want to use a condom, you can bet you are not the exception, but rather the rule. It is very possible that he (or she) infrequently uses condoms at all, which doesn’t bode well for his chances of avoiding an STD (or likely plural). What’s the message? Protect yourself and take the test, or be abstinent which is by far the best (albeit not very common) form of prevention. There is no shame in testing, but not knowing your results can hurt you and those you care about.