Primary Care Covers Sexual Health: Make Sexually Transmitted Infection (STI) Testing Part of Your Wellness Visit

One of the great things about primary care is that it looks at the wellness of the whole individual, including your sexual health. With routine screenings in place as recommended by your primary care provider, you’re able to stay on top of everything from flu shots and mental health check-ins to pap smears and sexually transmitted infection (STI) testing — all at your regular wellness visit.

While STI testing is not, by default, a part of an annual wellness visit, you can take control of your health and talk to your primary care doctor about prioritizing it. Doing so can help you with early disease detection as well as prevention. We can help you treat infections and walk you through any follow-up actions you may need to take.

Do I really need an STI test?

Regardless of your sexual history or sexual orientation, if you are sexually active, then yes, you should include STI testing as a part of your visit.

How often should I take an STI test?

That all depends on your sexual history and relationship status, age and sex, sexual orientation, and whether or not you’re pregnant. The Centers for Disease Control and Prevention (CDC) has a guide with special recommendations for STI testing, making it clear if you need special circumstance testing, annual testing, or interval testing. Interval testing can particularly benefit you if you’re between 13 and 65 years old, have never had an STI test, are in a monogamous relationship, and practice safe sex.

What does STI testing involve?

There are several ways to test for STIs. Since there are various kinds of STIs (human immunodeficiency virus (HIV), syphilis, chlamydia, gonorrhea, hepatitis B, and herpes (genital warts), different infections require either a swab, urine sample, or blood test. 

Who needs STI tests?

Here’s a brief overview of STI testing recommendations from the CDC:

• All adults and adolescents should be tested for HIV at least once
• Women under 25 who are sexually active — once a year for gonorrhea and chlamydia
• Women 25 and over with risk factors (new or multiple sex partners or a partner with an STD) — test for gonorrhea and chlamydia annually
• All pregnant people — test for syphilis, HIV, hepatitis B, and hepatitis C — early in pregnancy
• Pregnant and at-risk — test for chlamydia and gonorrhea early in pregnancy. Repeat testing may be necessary.
• All sexually active gay, bisexual, and other men who have sex with men:
  • Test once a year for HIV — interval testing may be beneficial every 3-6 months
  • Test once a year for syphilis, chlamydia, and gonorrhea — interval testing for those with multiple or anonymous partners every 3-6 months
  • Test once a year for hepatitis C if living with HIV
• Anyone who has more than one sexual partner or does not use condoms regularly should consider full STI testing, including an HIV test, once a year
• Someone who shares injection drug equipment or using intransal drugs — test, at minimum, once a year for HIV and Hepatitis C
• All who engage in oral or anal sex — talk with your provider about the throat and/or rectal testing options

While many people are understandably nervous about approaching the topic of STIs, be assured that MUSC Health providers and care team members are ready to talk and make you feel at ease discussing your routine STI tests.

Adrian Strand, M.D., MPH, is a board-certified family medicine physician at MUSC Health. Offering comprehensive primary care services for the whole family, her areas of interest include adolescent medicine, migrant and global health, care of the underserved, and geriatrics.