Dear Dr. D.,
Last night, I had unprotected sex with an individual who I didn't know. When should I get tested for STDs? If I do have an infection of some sort from last night, when will it show positive during a test?
Worried in E.L.
Dear Worried in E.L.,
I am going to assume that you might have some anxiety over this, so for that reason I will say that I am sorry to hear that this has happened.
Unfortunately, we know all too well that sex without protection does happen. Before I get to your question, let's address the issue I believe might be going on in your head. Sex without protecting yourself — or for that matter, your partner — does not mean you are going to contract an STI (sexually transmitted infection). All it means is that the possibility might have increased. As a former skydiver, the possibility of me "bouncing" from my chute not opening did increase if I did not check my gear in the air, but it did not mean that it was going to happen if I didn't.
STIs are not the result of having sex, they are what I like to call the logical consequence of certain behaviors while engaging in sex with an unknown partner. Hear me on this one: I am not endorsing the practice of not "protecting" yourself. What I am endorsing is the practice of "honest" education and dialogue about sexual behavior and not resorting to standard "fear" messages which tend to make people worry themselves sick after they have chosen to engage in sex.
Having said that, I am hoping that you had a choice in whether to have the intercourse unprotected, and if not, then that is a whole other issue. I am also aware that other factors (alcohol, etc.) involved can have a great impact on the choice to use protection or not. That being said, it's important to have the resources and knowledge to protect yourself even if you don't plan on having sex. It is possible to contract an STI from lack of adequate protection when having vaginal, oral or anal sex, as well as skin-to-skin contact. The best way to decrease the possibility is to practice safe sex techniques, educate yourself about STI transmission/risk factors, understand the limitations of STI testing and pay attention to symptoms. End of soapbox.
To your question: Some people might be encouraged or want to get an STI assessment right away after unprotected sex, while others decide to have the tests annually as part of their regular exam, while some still prefer to wait for symptoms before getting tested. As you may or may not know, STIs usually fall into three categories: bacterial, viral and parasitic. Depending on the type of STI, you can have a myriad of symptoms or none at all. You should get tested if you experience any of the following symptoms: unusual discharge, painful or burning urination, genital skin changes (rash, sore, blister, growths), pelvic discomfort or pain, or testicular pain.
Remember that a person who has contracted an STI might not experience any symptoms, and in other cases the symptoms might be caused by something other than an STI. If you think you might have been exposed to an STI, the recommendation is to wait two to three weeks after unprotected sex before getting a test.
An STI assessment consists of a brief sexual history, a physical examination, lab testing (urine sample, oral/vaginal/rectal swab, cervical culture or a blood draw) and, in some cases, health education. During your visit your clinician will tell you how to get your results. Some test results are given in person, while other results are available over the phone, 24 hours a day. To schedule an STI assessment, the on-campus place to go is Olin Health Center.
There is not enough space here to write about all the different tests, so if you have questions about kinds of tests, costs, etc., give us a call at Olin.
As a rule of thumb, I usually tell students that if you have chosen to be sexually active, and you have had sex without any protection and other factors might be involved, do yourself a favor and schedule an STI assessment. It does a person good to know.
By the way, skydiving is a lot more fun than sex.
Dr. D.
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