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Is there one STD test that can detect all STDs?

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Updated May 27, 2014

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

No. No single STD test can give you a full and accurate picture of your sexual health. All STD tests are not alike. I'm not simply talking about the fact that some tests are better than others - meaning, either very likely to identify everyone with the disease correctly, or never incorrectly tell an uninfected person that they have an infection.

If the e-mails I receive have taught me anything, it's that people make a lot of incorrect assumptions about specific STD tests being more comprehensive than they are. Some of the most common misconceptions about STD testing include:

  1. Getting a Pap smear is the same as getting screened for STDs.
    Many women assume that the Pap smear they get during their annual exam is also an STD test. It's not (although it may include an HPV test.) The fact is, if you haven't been asking your doctor for STD screening, it's possible that all she's been doing during your exam is a Pap smear. Many, many gynecologists do not routinely screen their patients for STDs, particularly if a woman is over 24 and if the doctor is in private practice. This means that many women remain unaware of asymptomatic STD infections for years, when they think they're being screened.
     
  2. A VDRL test can tell you if you have HIV.
    I get a shocking number of e-mails from people asking me to read their VDRL test results and tell them if the numbers mean they have HIV. I'm not sure where the belief that a VDRL test gives a patient's HIV status comes from, but it's clearly a common misconception. VDRL is only a test for syphilis, not for all viral STDs.
     
  3. An HIV test is all someone needs to find out if they have an STD.
    Another common misconception, but HIV tests only look for HIV. Furthermore, doctors will not always follow-up even a positive test result with routine STD screening.
     
  4. If a doctor tells you that you do have gonorrhea or chlamydia, it means you'll be fine after a course of antibiotics, and you don't have any STDs.
    Some doctors and clinics routinely screen young people for these two, extremely common, bacterial STDs, but do not test them for anything else. Unfortunately, when patients hear they have gonorrhea or chlamydia, and that it can be treated, they often assume that it also means they are free and clear of any other STDs. That isn't necessarily the case, however, and without additional tests for herpes, syphilis, other STDs can remain undetected and risk being unknowingly spread to a patient's partners.
     

The individual assumptions are all problematic, but they reflect an underlying issue that is even more unhelpful. People expect that their doctors will know how to test them appropriately and do so without them asking, so that they can be confident they're free of STDs. The problem is, that's not true. Not only are many doctors unaware of the range of STD testing options out there, even those who are aware may not routinely test their patients for the full range of STDs unless the patients request such comprehensive testing.

While there are some good reasons for not comprehensively STD testing the entire sexually active population, doing so without active acknowledgement of the fact contributes to a culture where many people are uninformed about their health status without realizing it - a very dangerous thing. Such false beliefs about infection status can lead to poor sexual decision making and regrets, anger, and experiences with partner blame that could be avoided if doctors and patients did a better job discussing issue of sexual health.

The best thing a person can do, if they're seeking STD testing, is to approach their doctor with a list of specific diseases they would like to be screened for. Or, alternatively, to say they wish to be comprehensively tested and ask what that means to their doctor. Then, if the doctor's definition of "comprehensive" doesn't include a disease they are concerned about (such as herpes), that test can be added in.

Conversely, if someone has been tested for STDs and received a positive or negative result from their doctor, it's important for them to ask exactly what they were tested for. It may turn out that they were only screened for HIV or chlamydia, and that's something they need to know.

In short, if you want to know whether you are free of STDs, you have to not only get tested but tested for everything you're concerned about, and you won't know if that's happened unless you ask. It's a burden that isn't necessarily fair to the uninformed health care consumer, but people need to be actively responsible for maintaining their own sexual health.

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