STI testing is often whispered about in hushed tones – it remains shrouded in shame, unnecessary stigma and misinformation, leading many people to avoid it despite being sexually active. Well, it’s time for that to change! Our comprehensive guide demystifies STI testing, exploring the realities of STIs, when tests are needed, and why regular testing is a normal, responsible part of sexual health – not something to worry about or be ashamed of. You’d go for your smear test so why not an STI check?
Introduction: why testing matters
The World Health Organization (WHO) estimated that in 2020, there were 374 million adults between the ages 15 and 49 globally with new infections of chlamydia, gonorrhoea, syphilis or trichomoniasis.
When we take a look a little closer to home, recent government data on sexual and reproductive health for England paints an equally worrying picture. Year on year, cases of STIs have been rapidly increasing. Whilst the most figures suggest that overall cases of STIs are slowly decreasing, so are the number of tests. This means it’s hard to say if the decline is linked to fewer people getting tested. Data from Gov.uk reveals that between 2023 and 2024 the number of STI related consultations in England decreased.
The truth is that STI rates are incredibly high and STI prevalence amongst young people in particular are continuing to rise. The most commonly diagnosed STI in 2024 was chlamydia which accounted for 46.3% of all new STI diagnoses; this was closely followed by gonorrhea 19.7% and genital herpes 7.6%. When comparing this data to previous years it is noted that there is an increase in infectious syphilis diagnoses.
The problem with these numbers
The worrying news about these numbers is that it suggests fewer individuals in England are prioritising their sexual health. Testing matters because if you don’t know you have an STI, you aren’t getting treated, and you can easily spread it to others.
Think you’d know if you had an STI? Think again! Most people with STIs have no symptoms. This is also referred to as being asymptomatic. Unfortunately, it means you could have an STI without even realising it. The issue with this goes beyond just the problem of spreading the condition – it can negatively impact many different areas of your health.
There are many surprising long-term side effects of some STIs. Indeed, because infections like chlamydia don’t usually show symptoms they often go undiagnosed. Unfortunately, when untreated, it can have a devastating impact on your reproductive health, leading to infertility, pelvic inflammatory disease, and pregnancy complications. It can be passed on to the baby during birth, potentially leading to issues with the lungs and eyes.
What STIs are commonly tested for
Bacterial infections
Chlamydia: This is one of the most common STIs in the UK. Many individuals with chlamydia are asymptomatic, which means they are unaware they even have it. The trouble is, when left untreated, it can lead to complications. Individuals with symptoms may experience a burning sensation when urinating, discharge from the vagina or penis, and pain.
Gonorrhoea: Another surprisingly common STI, gonorrhoea is also associated with discharge, burning during urination, and can even lead to pain or bleeding during sex. You may also experience fever. This condition can also be asymptomatic.
Syphilis: This STI is having somewhat of a resurgence at the moment and can lead to life-altering complications. Depending on how advanced the infection is you may experience a single painless sore on the genitals or mouth, a rash that isn’t itchy, warts in the gential area, swollen lymph nodes or glands, and flu-like symptoms. That being said, some individuals may have latent syphilis which has no symptoms.
Viral infections
HIV: Passed on through semen, vaginal fluid, anal mucus, and blood, HIV can lead to life-threatening illnesses and damage the immune system. You may experience symptoms including fever, rashes, fatigue, muscle and joint pain, sore throat, mouth ulcers, headache, night sweats, weight loss and diarrhoea. Unfortunately, these symptoms can be confused with other common illnesses. It is also possible to have HIV and not display any of these symptoms.
Hepatitis B & C: Fever, tiredness, aches and pains, nausea, and abdominal pain could indicate a Hep B or Hep C infection. You may also experience dark-coloured urine. But as with all other STIs, it’s possible to have the infection and be completely unaware of it.
Herpes (HSV-1 & HSV-2): Once infected with herpes, you have it for life. Spread through skin-to-skin contact (for example, oral or penetrative sex), it can sit inactive in the body for years. The majority of individuals will have no symptoms, but it is possible to experience flu-like symptoms, blisters in the affected area which then burst and leave sores. This may lead to pain when urinating. The majority of people have some form of herpes.
Who should get tested and how often
Let’s get down to the nitty gritty – when should you be tested for STIs?
- You should regularly be tested for STIs if:
- You are sexually active (get tested yearly – even if you are in a monogamous relationship)
- You have a new sexual partner (test before sex)
- If you have multiple partners
- If your partner has tested positive
- If you have any of the symptoms listed in the previous section of this article
- If you use condoms but one has broken
- After any sexual assault
Depending on the type of STI test, your healthcare provider may take a swab, blood sample, or urine sample for testing.
STI testing and your health
Ultimately, STI testing should be a normal part of being sexually active. It’s important that we all try to normalise sexual health testing as routine healthcare to curb the spread of infection.
The hard truth is that the only way to know for sure if you have an STI or not is to get tested.
The majority of individuals get tested via the NHS. However, if you are worried about anonymity, seeing someone you know at the clinic, or simply prefer the experience that comes with private healthcare, you may prefer to attend a private clinic, like this gynaecologist in London.
