There are over 50 sexually transmitted infections. Screening includes the most common STIs. STD screening is not automatically done as part of your Pap smear and annual exam and MUST be requested. You can let the medical assistant or your physician know you would like screening. If you would like to be screened for something that is not included on our standard panel. Please ask your doctor.
Our panel includes the following tests:
Sexually transmitted infection screening is recommended in the following circumstances:
No preparation is needed. STI testing can be performed at the time of your annual exam. If you would like testing done at any other time, call and make an appointment.
There are two components to screening. Gonorrhea, Chlamydia and Human Papilloma virus screenings require a cervical swab and is performed by inserting a speculum and placing a q-tip in the cervix.(Similar to a pap smear) An HPV test is NOT part of the standard panel. If you would like to be screened for HPV, please discuss it with your doctor. A pap smear screens for cervical changes that occur as a result of HPV. If the Pap is normal, HPV status will be checked only if you request it.
The remainder of the STI screen includes blood work. Our standard panel includes tests for Syphilis, Herpes, HIV, and Hepatitis
Results are ready within the week. Please provide us with a daytime number to call with results. Let us know if the number you give is confidential so we know if we can leave a voicemail. If you would prefer to call for results, let us know. The following is a brief summary of each STI on our panel and what your results mean:
Gonorrhea
Gonorrhea is caused by a bacterium (Neisseria gonorrhoeae) that is usually contracted during sexual intercourse. The bacterium can be passed on through mucous membranes of the mouth, throat, anus, urethra, and vagina. Ejaculation is not necessary to spread Gonorrhea. Contrary to popular belief, Gonorrhea cannot be transmitted via inanimate objects such as a toilet seat.
You may be at risk for Gonorrhea if you have a new sexual partner or multiple sexual partners, or if you have a previous history of gonorrhea.
Some people with the infection have no symptoms at all, so can often be spread before being detected, but there are several symptoms that indicate a gonorrhea infection such as:
Treatment of gonorrhea involves a one-time antibiotic treatment. This antibiotic may either be injected (ceftriaxone) or taken orally (cefixime).
If diagnosed with Gonorrhea, it is important to inform all current or recent sexual partners so that they can also be treated. This is especially important since people often have Gonorrhea without experiencing any symptoms. It is also possible to be reinfected after treatment if your current partner still has the infection. Therefore, sexual contact should be avoided until both partners have been treated and no longer have any symptoms. If you continue to experience symptoms after being treated, please tell your doctor.
Chlamydia
Chlamydia is caused by a bacterium (Chlamydia trachomatis) that is usually contracted during sexual intercourse. The bacterium can be passed on through mucous membranes of the mouth, throat, anus, urethra, and vagina. Ejaculation is not necessary to spread Chlamydia. Contrary to popular belief, Chlamydia cannot be transmitted via inanimate objects such as a toilet seat.
Some people with the infection have no symptoms at all, so can often be spread before being detected, but there are several symptoms that indicate a Chlamydia infection such as:
Chlamydia is treated with an antibiotic taken orally. If diagnosed with Chlamydia, it is important to inform all current or recent sexual partners so that they can also be treated.
Syphilis
Syphilis is caused by a type of bacterium (Treponema pallidum and is contagius whenever a sore or a rash is present.
There are four stages of syphilis.
Primary stage: During the the earliest stage a painless open sore called a chancre (pronounced "shanker") develops. Chances are often found in the genital area, anus, or mouth, but can be found wherever the bacteria entered the body.
Secondary stage: A skin rash occurs during the secondary stage, which usually begins 4 to 10 weeks after the initial infection. Secondary syphilis is highly contagious through direct contact with the mucous membranes.
Latent stage: The latent stage is defined as the year after a person becomes infected. A person in early latent stage may be contagious even though they usually have no symptoms.
Late (tertiary) stage: If syphilis is not detected and treated in the early stages, serious medical problems can occur.
Treatment
Antibiotics cure the infection at any stage. Antibiotic treatment cannot reverse the damage caused by the complications of late-stage syphilis, but it can prevent further complications.
Herpes
Genital herpes is caused by the herpes simplex virus. About one in five adults in the United States is infected with this sexually transmitted disease, but many with the disease do not even realize that they are infected because there are often no symptoms.
There are two types of herpes. The first, herpes simplex virus type 1 is most commonly the cause of oral herpes resulting in cold sores on the mouth and lips. HSV 1 can also appear on the genitals if it is transmitted through oral sex. The second is herpes simplex virus type 2, which is generally the cause for genital herpes. Type 2 reoccurs more frequently than type 1.
Determining virus type is important because a person with HSV 1 can still subsequently be infected with HSV 2 and vise versa.
Even if a person with herpes has no visual symptoms, it is still possible to pass the disease on to a partner during vaginal, anal, or oral sex. The risk is highest for men and women that receive anal sex. Herpes cannot be passed through inanimate objects such as a toilet seat.
The symptoms of genital herpes are generally most severe during the initial or primary episode, and get less severe in recurring episodes. During this first breakout, multiple blisters appear in the genital area and could continue to spread with new lesions appearing for up to seven days. It is also possible to get blisters on other areas besides the genitals such as your mouth and lips. You may also experience painful urination, swollen lymph nodes in the groin, and flu-like symptoms. Symptoms generally go away within two to three weeks. Then, the virus will go into a latent stage in which there are no visible symptoms because the virus has traveled to a bundle of nerves at the base of the spine where it rests inactive.
It is then possible to experience recurrent episodes of herpes when the virus returns to the skins surface. It is possible that the disease will remain dormant for 20 to 40 years after the initial infection is acquires. These outbreaks will result in the appearance of new ulcers, although recurrences are often much milder than the first outbreak and can even occur without any noticeable symptoms. People infected with type 2 herpes are more likely to have recurrent outbreaks than those infected with type 1. Often, there are symptoms that are experienced before a recurrent outbreak such as pain, itching, or tingling in the legs, hips, or buttocks.
While the first outbreak is generally the most severe, it is also possible to have no or very few symptoms during the first outbreak and more severe outbreaks later, thus it is often difficult to tell exactly when the virus was acquired.
While the risk of spreading the disease is highest during outbreaks, the virus is always present in the urinary and genital tract due to viral shedding. During periods in which no ulcers are present, called asymptomatic shedding or asymptomatic reactivation, it is still possible to transmit the disease between sexual partners.
It is important to try to come to the office within 48 hours of the first symptoms because the culture test is more likely to detect the herpes when ulcers are new and open than when they are older and healing. The test is also more likely to detect an initial episode of genital herpes than a recurrent episode.
If you have no visible ulcers but believe that you may have been exposed to herpes in the past, a blood test can be used. This test detects antibodies to HSV-1 and HSV-2. Antibody responses take some time, about three to four months after the initial episode, so this test may still have a negative result during the first episode of herpes. This antibody test will remain positive for life.
There is no cure for genital herpes, but, using antiviral drug therapy and self-care measures, one can manage the infection.
The two regimens of drug therapy for genital herpes are episodic therapy and suppressive therapy. Both treatments use antiviral medications (acyclovir, famciclovir, and valacyclovir), which are usually taken orally in pill form.
Episodic therapy uses antiviral drugs as soon as the symptoms begin. After 7 to 10 days, the medication is stopped. This treatment can alleviate pain, shorten the healing time of ulcers, and reduce the duration of viral shedding (when the virus can be transmitted to a partner).
This therapy is usually recommended for those with less than six recurrences each year. Antiviral treatment of recurrent episodes works most effectively when started within 24 hours of the first symptoms.
Suppressive therapy uses antiviral drugs continuously, even when there are no symptoms. Suppressive therapy decreases the number of recurrences, lengthens the time between recurrences, shortens the duration of symptoms during a recurrence, and can reduce the risk of transmitting HSV to a partner.
This therapy is usually recommended for those who have more than six recurrences each year and those with a weaker immune system. Suppressive therapy is also beneficial for people who are in a sexual relationship with a partner who does not have genital herpes. This treatment reduces transmission to the susceptible person by about 50%.
Local treatments may also be used to relieve the pain of a herpes outbreak. A Sitz bath can temporarily decrease pain. This can be done by sitting in a few inches of cool water (without soap or bubbles) in a bathtub or a specially designed sitz bath, which is available at most pharmacies without a prescription. It is also helpful to avoid tight or irritating underwear and clothing and to keep the genital area clean and dry.
Being diagnosed with genital herpes does not mean that you cannot have a safe and healthy sex life, but it is very important to take precautions. While using a latex condom with every sexual encounter reduces the risk that a male will pass the herpes virus to a female, they are less affective at preventing a female from infecting a male. However, there is still some benefit to using one. Even when no visual symptoms are present, a condom is still recommended. When genital ulcers are present, sex should be avoided altogether. The same goes for oral sex if ulcers or blisters are present around the mouth.
Hepatitis
Hepatitis is simply inflammation of the liver. A specific type of Hepatitis, called Hepatitis B, is caused by a virus that is most commonly spread by sharing needles when injecting drugs or by unprotected sexual intercourse. This virus can survive outside of the body for along period of time, so it can be transmitted by sharing personal items including toothbrushes and razors.
Hepatitis can be confirmed through several hepatitis markers found in blood, which are substances called antigens that are produced by Hepatitis B and antibodies produced by the immune system to control and eliminate the virus. The levels of these markers can differentiate acute from chronic infection.
If you screen positive for hepatitis, you will be referred to a specialist who treats liver disease.
HIV
HIV or Human immunodeficiency virus weakens the body's immune system, which makes it difficult to fight infections and cancer.
It is possible to have HIV without having any symptoms. Even without symptoms, the illness can be passed on through sexual contact or exposure to contaminated needles.
Without treatment, HIV can cause extreme illness and even death. When the infection is in its most advanced stages, it is called AIDS (acquired immune deficiency syndrome).
It is recommended that you are tested for HIV if:
To test for HIV, a small blood sample is taken. This test is more than 99 percent accurate. A test can be positive, negative, or indeterminate. When a test is positive, it is confirmed with another test. If a false negative result occurs, it is most likely because the test took place before HIV antibodies were made. One can be tested for HIV at any time, but it is suggested to have a repeat test done at 6, 12, and 24 weeks after suspected exposure.
Can you test my male partner?
We will do blood work on your male partner but are not able to exam him or do urethral swabs.
If I test positive, can you treat my partner as well?
It depends. We will let you know on a case-by-case scenario.
What if I don't want results on my chart?
Our charts are confidential. That means no one will see your chart without your written permission. If an insurance company or someone else requests your chart, once you have given your permission to duplicate records we are obligated, by law, to reproduce the chart in it's entirety, including STI screening. If you do not want your results on the chart, a Chicago Board of Health Clinic can test you anonymously.
What if I don't want a positive result reported to the Board of Health?
We are obligated, by law, to report certain test results to the board of health.
What if I don't want the bill for screening to appear on my insurance?
You are welcome to pay out of pocket, and we will not submit the bill to your insurance company.
What if I am covered on my parents' insurance plan but I don't want my parents to know I had STI screening?
You can pay for testing out of pocket and it will not be sent to your insurance company or appear on the bill. You need to tell us this when you check in or out to assure a separate bill is done for testing.
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