STI testing: where to go and what happens

You can have an STI without knowing it. Testing is useful even when nothing hurts and there is no change in discharge. The tests you need depend on your sexual history, symptoms and other factors.

Choosing where to go

In the UK, anyone can attend a sexual health clinic, including people without symptoms. These clinics may also be called GUM or sexual and reproductive health clinics. NHS STI tests are free. Some free chlamydia home-test services are available for under 25s; check what is offered locally.

In the US, your usual healthcare provider can discuss testing. CDC also points to clinics offering confidential, free or low-cost tests. When booking, ask about the full cost, how results are sent and whether any paperwork will go to an insurance policyholder.

What the clinician will ask

A doctor or nurse may ask when you last had sex, whether condoms were used and whether you have symptoms. Mention oral or anal sex too: throat or rectal testing may be relevant. If you are unsure why they are asking something, ask them to explain.

Give the date of a possible exposure if you can, and say if you are estimating. A short note can make this easier if the appointment feels awkward. You could begin with, “I’d like testing, but I’m not sure which samples I need.”

Samples and examinations

STI tests may involve urine, blood or swabs from the vagina, throat or rectum. Chlamydia and gonorrhoea testing can often use a urine sample or a vaginal swab you take yourself. The clinic can explain which samples fit the tests being offered.

You can ask a UK clinic for a female or male clinician, and for someone to be with you during a test or examination. This could be a friend, family member or another member of staff. Tell the clinic what you would prefer when you book.

Home testing can involve collecting your own sample and sending it to a laboratory. Before ordering a kit, ask which infections and body sites it covers, how to return it, and who provides treatment or follow-up.

Go to A&E now (UK), or an emergency department (US and elsewhere), for severe or worsening pelvic pain, or pelvic pain with faintness or heavy vaginal bleeding. Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US and elsewhere), for pelvic pain with unusual discharge or bleeding. Do not wait for a home-test result or a routine testing appointment in these situations.

Confidentiality and getting the results

UK sexual health clinic staff do not tell your GP or others about your discussion without permission. There is a safeguarding exception if staff think you or someone else is at risk of harm; NHS guidance says they will talk to you before sharing information.

Clinics may send results by phone, text or an unmarked letter. Tell them which contact details are safe to use. Ask whether they contact everyone or only people needing follow-up, and what to do if you hear nothing.

US recommendations and test timing

CDC recommends yearly chlamydia and gonorrhoea testing for sexually active women younger than 25 years. Some women 25 years and older also need yearly testing, including those with a new partner, several partners or a partner with an STI. Discuss which recommendations apply to your anatomy and sexual history.

CDC recommends at least one HIV test for everyone aged 13 to 64 years. During pregnancy it recommends testing early for syphilis, HIV, hepatitis B and hepatitis C. Your clinician can explain whether additional tests are needed.

No HIV test can detect infection immediately. The time until it can do so is called the window period, and repeat testing may be needed after a recent exposure. Ask the clinic when to test and whether to return.

When to contact a service

Go to A&E now (UK), or an emergency department (US and elsewhere), for severe or worsening pelvic pain, or pelvic pain with faintness or heavy vaginal bleeding.

Contact an urgent GP service or NHS 111 today (UK), or your doctor or urgent care service (US and elsewhere), for pelvic pain with unusual discharge or bleeding. Do not wait for a home-test result or a routine testing appointment.

Go now to a sexual health clinic or A&E in the UK, or an emergency department or urgent sexual health service elsewhere, after possible HIV exposure within 72 hours. Ask about PEP; do not wait for a home kit.

For other testing concerns, contact a sexual health clinic or doctor. If an infection is found, arrange an appointment to discuss treatment as advised. UK clinics can usually notify partners without naming you, so you can ask for help with that conversation.