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Do I need special tests to see if I have an anal STD?

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Updated May 21, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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Question: Do I need special tests to see if I have an anal STD?
There are a lot of anal sex risks, particularly if you're not practicing anal safe sex. Numerous STDs are easily spread by anal sex, and if you have an anal STD it may not be detected by regular STD testing. That's why it's important to tell your doctor if you're having anal sex so that she can test you accordingly.
Answer: Not all STD tests work in the same way. Some tests, like the ones for HIV, test your blood for signs that your body has been exposed to the virus. If you wait long enough after infection for your body to have time to develop a response to the infection, a test like this will detect a disease no matter how you have been exposed.

In contrast, the tests for gonorrhea, chlamydia, and many other STDs look for the pathogen that causes the disease rather than your body's response to it. These tests, when performed the usual way, will not always be able to detect an STD that you have contracted through anal sex.

The fact that standard STD testing will not always detect an anal STD is one of the biggest anal sex risks. That's why it's so important to tell your physician if you are having receptive anal sex -- particularly if you are not having safe anal sex. If your doctor knows that you are at risk of contracting an anal STD, she can test you accordingly. This testing may include an anal Pap smear as well as swabs of the rectum to look for specific bacterial STDs that are frequently transmitted when individuals don't practice safe anal sex.

Anal sex risks are not just an issue for gay men. Many heterosexual couples and lesbians also have anal sex, which is why all sexually active adults should be aware of the possibility of anal STDs and know that these STDs require separate testing. Physicians also need to do a better job of asking their patients if they are having anal sex and encouraging them to have safe anal sex as part of their sexual health discussions. Not only is detecting anal STDs difficult during a standard screening exam if doctors don't know their patients are at risk, there may be specific treatment concerns for anal STDs such as rectal chlamydia and gonorrhea.

In conclusion, if you are having anal sex, it is essential to talk to your doctor about getting special tests to check for anal STDs. These tests generally involve a few swabs of your rectum with something no larger than a q-tip, and shouldn't be anything to fear.

Don't be too embarrassed to discuss your anal sex and safe anal sex practices with your doctor. There's no other way for her to know how to treat you appropriately. The anal sex risks are great enough that most doctors will appreciate your being up front about your habits so that they can give you the best care possible.

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