If your healthcare provider isn’t recommending testing forsexually transmitted infections (STIs)there could be a variety of reasons—both reasonable and concerning—as to why.
It’s helpful to have a sense of what may shape a decision not to test for STIs so you can have a conversation with your healthcare provider about whether or not you feel the move is right for you.
Here are 10 such reasons, plus information on why you might (or might not) want to get a particular STI test.
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Screening guidelines exist for a reason. Their goal is to target the highest-risk populations and maximize testing efficiency while minimizing a waste of time, money, and resources. The problem is that this doesn’t account for individual case considerations.
There are many reasons why people might wish to be tested for STIs more often than guidelines recommend. There are also reasons why people might be tested at an age when the guidelines don’t recommend testing at all.
Such reasons might include:
If you have any reason why your healthcare provider should deviate from the normal screening guidelines in your case, bring it up. If you’re still met with a “no” or you can’t get a referral, consider getting a second opinion.
2They Lack Access to the Right LabSome diagnostic tests require specialized collection equipment, tools, or laboratory supplies. Not all healthcare providers have these at their disposal.If you want or need to be tested for a disease, and your healthcare provider doesn’t have the required materials, then the only solution is to seek a healthcare provider or lab that does. Your healthcare provider may even have a provider or lab that they refer patients to regularly.This will mainly be an issue for certain urine tests,bacterial cultures, and swab tests (i.e., forbacterial vaginosisortrichomoniasis) rather than blood tests. However, some blood tests do require special collection tubes or types of preparation that may not be available in all healthcare providers’ offices.
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They Lack Access to the Right LabSome diagnostic tests require specialized collection equipment, tools, or laboratory supplies. Not all healthcare providers have these at their disposal.If you want or need to be tested for a disease, and your healthcare provider doesn’t have the required materials, then the only solution is to seek a healthcare provider or lab that does. Your healthcare provider may even have a provider or lab that they refer patients to regularly.This will mainly be an issue for certain urine tests,bacterial cultures, and swab tests (i.e., forbacterial vaginosisortrichomoniasis) rather than blood tests. However, some blood tests do require special collection tubes or types of preparation that may not be available in all healthcare providers’ offices.
They Lack Access to the Right Lab
Some diagnostic tests require specialized collection equipment, tools, or laboratory supplies. Not all healthcare providers have these at their disposal.
If you want or need to be tested for a disease, and your healthcare provider doesn’t have the required materials, then the only solution is to seek a healthcare provider or lab that does. Your healthcare provider may even have a provider or lab that they refer patients to regularly.
This will mainly be an issue for certain urine tests,bacterial cultures, and swab tests (i.e., forbacterial vaginosisortrichomoniasis) rather than blood tests. However, some blood tests do require special collection tubes or types of preparation that may not be available in all healthcare providers’ offices.
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They Do Not Know the Guidelines
Even in populations that are at high risk, healthcare providers may be hesitant to test for HIV for a variety of reasons. Sometimes, they simply don’t realize that they should.
4If They Screen, They Must TreatOne of the reasonsPap smearguidelines have changed is the problem of overtreatment. The Pap screening test itself is very safe. However, follow-up biopsies and treatments that can follow an abnormal result can cause unnecessary damage to a person’s cervix and long-term reproductive health.Studies have shown that, if left untreated, many precancerous lesions will eventually spontaneously resolve on their own. Testing, then, may reveal an infection that really could just be left alone.Unfortunately, many healthcare providers are afraid to screen andnot treat. If watchful waiting without treatment turns out to be the wrong decision, there may be legal consequences. This is a real and understandable fear that may make it easier for them to simply screen less often in the first place.
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If They Screen, They Must TreatOne of the reasonsPap smearguidelines have changed is the problem of overtreatment. The Pap screening test itself is very safe. However, follow-up biopsies and treatments that can follow an abnormal result can cause unnecessary damage to a person’s cervix and long-term reproductive health.Studies have shown that, if left untreated, many precancerous lesions will eventually spontaneously resolve on their own. Testing, then, may reveal an infection that really could just be left alone.Unfortunately, many healthcare providers are afraid to screen andnot treat. If watchful waiting without treatment turns out to be the wrong decision, there may be legal consequences. This is a real and understandable fear that may make it easier for them to simply screen less often in the first place.
If They Screen, They Must Treat
One of the reasonsPap smearguidelines have changed is the problem of overtreatment. The Pap screening test itself is very safe. However, follow-up biopsies and treatments that can follow an abnormal result can cause unnecessary damage to a person’s cervix and long-term reproductive health.
Studies have shown that, if left untreated, many precancerous lesions will eventually spontaneously resolve on their own. Testing, then, may reveal an infection that really could just be left alone.
Unfortunately, many healthcare providers are afraid to screen andnot treat. If watchful waiting without treatment turns out to be the wrong decision, there may be legal consequences. This is a real and understandable fear that may make it easier for them to simply screen less often in the first place.
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They Do Not Understand Your Motives
If you are seeking screening either because you have a known exposure or are considering starting a new relationship and want to know where you stand, explain your logic to your healthcare provider.
They may be more willing to screen you in the absence of symptoms if they understand that you have a good reason to want to know your STI status.
6They Don’t Know STI Test ProtocolsThe diagnostic tests that are available change over time. As such, healthcare providers may not be aware of every new test as it comes about (e.g., urine testing forchlamydiaandgonorrhea).Your healthcare provider may also know that a test exists but doubt whether it is smart to use on you. If that is the case, discuss their concerns. They may be legitimate.For example, many healthcare providers are extremely concerned about the potential emotional consequences of afalse positive testresult. This may be particularly true for rapid HIV tests, which are not as accurate as lab tests.
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They Don’t Know STI Test ProtocolsThe diagnostic tests that are available change over time. As such, healthcare providers may not be aware of every new test as it comes about (e.g., urine testing forchlamydiaandgonorrhea).Your healthcare provider may also know that a test exists but doubt whether it is smart to use on you. If that is the case, discuss their concerns. They may be legitimate.For example, many healthcare providers are extremely concerned about the potential emotional consequences of afalse positive testresult. This may be particularly true for rapid HIV tests, which are not as accurate as lab tests.
They Don’t Know STI Test Protocols
The diagnostic tests that are available change over time. As such, healthcare providers may not be aware of every new test as it comes about (e.g., urine testing forchlamydiaandgonorrhea).
Your healthcare provider may also know that a test exists but doubt whether it is smart to use on you. If that is the case, discuss their concerns. They may be legitimate.
For example, many healthcare providers are extremely concerned about the potential emotional consequences of afalse positive testresult. This may be particularly true for rapid HIV tests, which are not as accurate as lab tests.
7They Don’t See the BenefitSome healthcare providers may underestimate your risk of having an STI or contracting an infection from someone who doesn’t have symptoms. They may be hesitant to screen people for asymptomatic diseases, particularly those without serious long-term health risks.However, herpes and HIV are examples of STIs that can be transmitted in the absence of symptoms, even if suppressive therapies are being used.Knowing your status is especially important if your behavior may be putting a new sexual partner at risk. Advocate for yourself if you feel testing is indeed necessary, even if it’s just for your peace of mind.Also remember that there may be cases where you think you should be screened for an STI, but your healthcare provider doesn’t want to give you the test because they know something about your individual condition or risk factors that you don’t.For example, you might want a test because you are worried about white vaginal discharge, but your healthcare provider notes that the consistency is characteristic of a yeast infection, not an STI.
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They Don’t See the BenefitSome healthcare providers may underestimate your risk of having an STI or contracting an infection from someone who doesn’t have symptoms. They may be hesitant to screen people for asymptomatic diseases, particularly those without serious long-term health risks.However, herpes and HIV are examples of STIs that can be transmitted in the absence of symptoms, even if suppressive therapies are being used.Knowing your status is especially important if your behavior may be putting a new sexual partner at risk. Advocate for yourself if you feel testing is indeed necessary, even if it’s just for your peace of mind.Also remember that there may be cases where you think you should be screened for an STI, but your healthcare provider doesn’t want to give you the test because they know something about your individual condition or risk factors that you don’t.For example, you might want a test because you are worried about white vaginal discharge, but your healthcare provider notes that the consistency is characteristic of a yeast infection, not an STI.
They Don’t See the Benefit
Some healthcare providers may underestimate your risk of having an STI or contracting an infection from someone who doesn’t have symptoms. They may be hesitant to screen people for asymptomatic diseases, particularly those without serious long-term health risks.
However, herpes and HIV are examples of STIs that can be transmitted in the absence of symptoms, even if suppressive therapies are being used.
Knowing your status is especially important if your behavior may be putting a new sexual partner at risk. Advocate for yourself if you feel testing is indeed necessary, even if it’s just for your peace of mind.
Also remember that there may be cases where you think you should be screened for an STI, but your healthcare provider doesn’t want to give you the test because they know something about your individual condition or risk factors that you don’t.
For example, you might want a test because you are worried about white vaginal discharge, but your healthcare provider notes that the consistency is characteristic of a yeast infection, not an STI.
8They Worry About Potential StigmaOne of the biggest issues surrounding testing for highly socially stigmatized diseases such as genital herpes andgenital wartsis that some healthcare providers believe that the emotional trauma of a diagnosis causes more harm than the potential for spreading a disease asymptomatically.It’s true that finding out you have herpes or genital warts can be a life-changing experience. It can induce major depression, affect social and romantic relationships, and overall have a highly negative impact on someone’s life—even if they never have symptoms.Combined with the fact that you may live your whole life never knowing you are living with one of these infections, some healthcare providers question if there is a real benefit to doing the test.
8
They Worry About Potential StigmaOne of the biggest issues surrounding testing for highly socially stigmatized diseases such as genital herpes andgenital wartsis that some healthcare providers believe that the emotional trauma of a diagnosis causes more harm than the potential for spreading a disease asymptomatically.It’s true that finding out you have herpes or genital warts can be a life-changing experience. It can induce major depression, affect social and romantic relationships, and overall have a highly negative impact on someone’s life—even if they never have symptoms.Combined with the fact that you may live your whole life never knowing you are living with one of these infections, some healthcare providers question if there is a real benefit to doing the test.
They Worry About Potential Stigma
One of the biggest issues surrounding testing for highly socially stigmatized diseases such as genital herpes andgenital wartsis that some healthcare providers believe that the emotional trauma of a diagnosis causes more harm than the potential for spreading a disease asymptomatically.
It’s true that finding out you have herpes or genital warts can be a life-changing experience. It can induce major depression, affect social and romantic relationships, and overall have a highly negative impact on someone’s life—even if they never have symptoms.
Combined with the fact that you may live your whole life never knowing you are living with one of these infections, some healthcare providers question if there is a real benefit to doing the test.
9They Do Not See You As “at Risk”It’s easy to get tested for STIs if you’re young and unmarried. But if you’re older, many healthcare providers may not be as worried about you as they should be.In part, this is because young people are actually at greater risk of STIs. It’s also because the older you get, the less sex your healthcare provider tends to think you are having.Healthcare providers are more likely to suggest STI screening, or agree to screen you if they think of you as “at risk.” It’s a false choice, though, because even many people who seem to be at low risk are far from risk-free.
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They Do Not See You As “at Risk”It’s easy to get tested for STIs if you’re young and unmarried. But if you’re older, many healthcare providers may not be as worried about you as they should be.In part, this is because young people are actually at greater risk of STIs. It’s also because the older you get, the less sex your healthcare provider tends to think you are having.Healthcare providers are more likely to suggest STI screening, or agree to screen you if they think of you as “at risk.” It’s a false choice, though, because even many people who seem to be at low risk are far from risk-free.
They Do Not See You As “at Risk”
It’s easy to get tested for STIs if you’re young and unmarried. But if you’re older, many healthcare providers may not be as worried about you as they should be.
In part, this is because young people are actually at greater risk of STIs. It’s also because the older you get, the less sex your healthcare provider tends to think you are having.
Healthcare providers are more likely to suggest STI screening, or agree to screen you if they think of you as “at risk.” It’s a false choice, though, because even many people who seem to be at low risk are far from risk-free.
10
It Isn’t Their Area of Expertise
Who should test you for sexually transmitted infections? Your primary care physician? Your gynecologist? Your urologist? Dermatologist?
Realistically speaking, any of those healthcare providers could test you for most STIs. But STI screening isn’t always available in every clinic.
SpecializedSTI clinicsshould have healthcare providers on site who are trained in performing tests (like collecting a sample from a sore) and should have all of the equipment needed to test for STIs.
The United States Preventive Services Task Force (USPSTF) recommends that clinicians screen for HIV infection in adolescents and adults ages 15 to 65 years.The CDC recommends that everyone between the ages of 13 and 64 be tested for HIV at least once as part of routine health care. For those at higher risk, the CDC recommends getting tested at least once a year.
The Best At-Home STI Tests
3 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zheng MY, Suneja A, Chou AL, Arya M.Physician barriers to successful implementation of US Preventive Services Task Force routine HIV testing recommendations.J Int Assoc Provid AIDS Care. 2014;13(3):200-205. doi:10.1177/2325957413514276Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS.Screening for cervical cancer with high-risk human papillomavirus testing: updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2018;320(7):687-705. doi:10.1001/jama.2018.10400Centers for Disease Control and Prevention.How to get tested for HIV.
3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Zheng MY, Suneja A, Chou AL, Arya M.Physician barriers to successful implementation of US Preventive Services Task Force routine HIV testing recommendations.J Int Assoc Provid AIDS Care. 2014;13(3):200-205. doi:10.1177/2325957413514276Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS.Screening for cervical cancer with high-risk human papillomavirus testing: updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2018;320(7):687-705. doi:10.1001/jama.2018.10400Centers for Disease Control and Prevention.How to get tested for HIV.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Zheng MY, Suneja A, Chou AL, Arya M.Physician barriers to successful implementation of US Preventive Services Task Force routine HIV testing recommendations.J Int Assoc Provid AIDS Care. 2014;13(3):200-205. doi:10.1177/2325957413514276Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS.Screening for cervical cancer with high-risk human papillomavirus testing: updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2018;320(7):687-705. doi:10.1001/jama.2018.10400Centers for Disease Control and Prevention.How to get tested for HIV.
Zheng MY, Suneja A, Chou AL, Arya M.Physician barriers to successful implementation of US Preventive Services Task Force routine HIV testing recommendations.J Int Assoc Provid AIDS Care. 2014;13(3):200-205. doi:10.1177/2325957413514276
Melnikow J, Henderson JT, Burda BU, Senger CA, Durbin S, Weyrich MS.Screening for cervical cancer with high-risk human papillomavirus testing: updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2018;320(7):687-705. doi:10.1001/jama.2018.10400
Centers for Disease Control and Prevention.How to get tested for HIV.
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