1. Chances are, you’re not getting tested as often as you should.
And that’s probably not your fault. “Young men typically drop off from seeing a primary care provider around 15,” says Bell. And since you aren’t going to the gynecologist every year, you probably don’t have an annual opportunity to talk about sexual health with a physician.
“The culture around STI testing is very negative I think for men and women,” says Bell. “But for women, there can be an enveloping of those services around pregnancy prevention, so when they’re accessing services for contraception, STI services are a part of that. It doesn’t have as much of a negative connotation as plain STI testing. Guys don’t have a way around that.”
Basically, the responsibility to know when to get tested — and for what — seems to be on your shoulders, which is often why so many people don’t.
2. Don’t worry, you probably won’t have a Q-tip stuck up your penis.
If you heard horror stories about — or even experienced — a Q-tip up the urethra, you might be understandably squeamish about getting tested. Luckily, that’s not necessary anymore. “At this point in time, if someone tells you you have to get a Q-tip, you should tell them you know for a fact you can urinate in a cup for a test,” says Bell.
Chlamydia, gonorrhea, and trichomoniasis can be tested with a urine sample; while HIV, syphilis, herpes, and hepatitis B can all be tested with a blood test. Easy peasy.
3. Most of the time, STIs are totally symptomless. So just because you look/feel OK, that doesn’t mean you’re in the clear.
But my penis looks totally fine! Well, that doesn’t mean much. “The absence of symptoms certainly shouldn’t assure someone that they don’t have an STI,” says Leone.
In fact, the vast majority of people with genital herpes don’t know they have it, according to the CDC. And some research has shown that up to 90% of men with chlamydia had no symptoms at all, says Bell. So if you only get tested when something is up with your penis, you’re waiting too long.
4. But if you do notice any symptoms, go to the doctor.
Some of the most common symptoms associated with STIs include: burning when you pee, an unusual discharge (from the urethra or rectum), rectal pain, or any sort of sore/ulcer/unusual bump around the genital area.
With gonorrhea, the discharge could look like white or yellow pus, but with chlamydia it could look clear and sticky. Guys often confuse this with pre-ejaculate, says Bell, so if you notice a discharge that’s not associated with an erection (and you’ve had unprotected sex), see a doctor.
And keep in mind that symptoms aren’t always limited to your crotch area. Syphilis can also present with a rash on the hands and feet as well as vision changes, says Leone. And mouth sores could signal an oral infection. So basically, any weird lumps, bumps, or pains should be checked out.
5. If you don’t know your HIV status, go ahead and get tested.
Everyone who’s had sex should know their HIV status — not only to avoid infecting others but also to get the appropriate care as soon as possible. The CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once, but you should be retested depending on certain risk factors (outlined here).
Bell and Leone suggest — at the minimum — getting tested for HIV any time you change partners that you’ve had unprotected sex with. So if you’re newly single and you and your ex weren’t using condoms, get tested before you have a new partner so that you know your status going into your next relationship.
6. If you have sex with men, you should probably get an HIV test more frequently.
According to the CDC, men who have sex with men (MSM) should get an HIV test at least once a year. But that recommendation also depends on your sexual and relationship status, says Bell. For instance, if you know you’re in a mutually monogamous relationship (and have been since the last time you were tested together), or if you’ve been on a 16-month dry spell, you may not need to get retested that year.
But if you have multiple partners, anonymous partners, or if your partner may have multiple partners, you may need an HIV test every three months, says Bell.
7. You should also get tested for STIs any time you have a new partner.
Regardless of who you’re having sex with. This way you’ll know you’re chlamydia-, gonorrhea-, and syphilis-free before you have sex with someone else.
Again, the CDC guidelines for MSM suggest STI screening at least once a year, or more often if you’re at a higher risk (like if you have HIV, if you have multiple or anonymous partners, or if your partner may have other partners). High-risk individuals should get screened at 3- to 6-month intervals.
8. Fun fact: You should also get tested in your mouth and anus if you’ve had any sexual activity there.
Peeing in a cup can test for infections in your urethra, but that’s not the only place you can have chlamydia and gonorrhea infections. Those can also occur in the throat and rectum, so if your mouth or anus comes into play during sex (like oral sex, rimming, pegging with a sex toy that’s also been in your partner, etc.), then you should be testing those sites, too. “Unless you’re damn sure nothing has been in your throat or rectum, get it screened,” says Leone.
This is called “extra-genital testing” (meaning you’re testing places other than your genitals) and many clinics, labs, and hospitals will offer these tests, says Leone. The thing is, you might have to be the one to ask for it. Unfortunately, “most providers are uncomfortable talking about oral or anal sex,” says Leone.
9. Trans-identified folks should get tested regularly, too.
The most crucial step for transgender individuals will be finding clinicians who are knowledgeable about and respectful of health issues affecting trans people, says Leone. That’s because your STI and HIV screening recommendations will differ depending on your parts, your partner’s parts, and the sites at which you have sexual contact.
The technology is there to test you wherever you’re having sex, says Leone, but having a provider who can ask the right questions in a safe and non-judgmental way will make all the difference. You can search for LGBT-friendly providers in your area here.
10. Keep in mind that HIV and some STIs take a while to show up on tests.
A urine sample can pick up chlamydia and gonorrhea within a few days of exposure, but blood tests typically require more time to detect the antibodies of a virus. For instance, syphilis can take weeks to months to show up on test, so be wary of that when getting tested between partners.
Some of the newer fourth-generation HIV tests can detect the virus as early as two weeks after exposure, while others can take up to a few months, says Bell. That’s why experts suggest HIV testing at 3- or 6-month intervals for anyone at a high risk.
11. If your partner has an STI, you can probably get meds ASAP.
So you found out someone you’re dating (or dated, or hooked up with, or whatever) has an STI. In most states, their doctor can actually give them an extra dose of antibiotics for you to take, which is called expedited partner therapy (you can check here to see if your state allows it). You should definitely still get tested (especially since having one STI can put you at a higher risk for others), but getting treated ASAP is also great.
12. When left untreated, STIs can do serious damage.
The main danger associated with untreated STIs is passing them to partners, says Leone. If you have a female partner, an untreated STI can lead to pelvic inflammatory disease and even infertility.
But unknown STIs can affect your own body, too. Having one STI can put you at a higher risk for contracting other STIs and HIV. Untreated gonorrhea and chlamydia can sometimes lead to an infection in the testicles called orchitis, or scarring in the urethra; while HPV can be major risk factor for anal cancer. Untreated syphilis can lead to vision loss and damage to the internal organs and nervous system, which could be fatal.
So just because you can’t see it, can’t feel it, and don’t know you have it — that doesn’t mean it’s harmless.
13. There are lots of places that offer cheap (and sometimes free) testing to men.
The experts recommend public health departments (find ones in your state here), Planned Parenthood clinics, or sexual health clinics for free or discounted screening. Or you might be able to get screened at your primary care doctor or an urgent care near you.
You can also visit GetTested.CDC.gov to find testing centers near you. “Put your zip code in and it gives you sites we’re aware of that you can generally access free, same-day appointments,” says Bolan.
14. There are vaccines for some STIs and you should definitely get them if you’re eligible.
HPV is incredibly common, and while most strains will clear up on their own, others can lead to genital warts or cancer. So if you didn’t get the HPV vaccine when you were younger, you might still be able to catch up. The CDC recommends the vaccine for men through age 21, or through age 26 if you have sex with men or have a compromised immune system (including HIV infection).
And you probably got the hepatitis B vaccine as an infant, but if you didn’t, you can also get tested and vaccinated as an adult.
15. If you’re at risk for HIV, you should also know about pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
PrEP is a daily medication that can reduce the sexual transmission of HIV by up to 92% when used consistently. The CDC recently found that roughly 1.2 million people should be taking it. Find out more about PrEP here, and talk to you doctor about whether or not you’d be a good candidate.
There’s also PEP, a medication that can reduce your chances of HIV infection when taken within 72 hours after you’ve been exposed. According to the CDC, if you think you’ve been exposed, you should ask your doctor or an emergency room physician about it as soon as possible.
16. If you’re not sure if you need to get tested, just go in for a risk assessment.
This is just a simple check-up with a physician (at your primary care office, a health department, sexual health clinic, etc.) where they’ll ask you some questions about your sexual activities and your partners. Stuff like how many partners you’ve had, how often you use condoms, what kinds of body parts are usually involved when you have sex, etc.
Be honest. “If they’re not disclosing risk factors, they may not be tested when they need to be tested,” says Bolan. “I can’t take good care of you if we can’t have an honest discussion.”
They might even tell you that you don’t need a test at this time, especially if you’re in an area where STIs aren’t super prevalent and you don’t have any risk factors. “You’re still getting good care when a provider says ‘I’ve done your risk assessment and right now, getting this test isn’t going to help you,’” says Bolan.
17. Don’t assume it won’t happen to you.
Regardless of who you have sex with, how many partners you’ve had, or how consistently you use condoms, you’re still responsible for knowing your status.
“That ‘I’m-not-the-type-of-person-who-gets-it’ is something we need to get past,” says Leone. “Being a sexually active adult, you’re probably going to have an STI. It could be HPV or it could be something relatively rare. It’s part of your health and wellbeing to just do this. Just go out and get screened.”
FYI: Most experts now use the term STI (sexually transmitted infections) rather than STD (sexually transmitted diseases), since most of the time these are infections without any visible symptoms.