STI/STD Testing Windows – When To Get Tested for STDs

Comments

1. Heart

   October 23, 2013 at 10:55 AM

   Thank you so much for this. Most resources I’ve found are either hopelessly vague (“…within a few weeks, depending on the infection”) or frankly seem to assume that I have infinite money and can get tested for everything at 2 weeks, and then at 3 weeks, and again at 4 weeks, ad nauseum. I’m sure they’re just trying to cover their asses, but I need real advice, and if I spend my money on a std panel at 2 weeks out, I simply *cannot* afford another before the six month “just checking” test.

   • Jenelle Marie

     October 24, 2013 at 10:49 AM

     No problem – glad we could help!

2. Daniel

   December 14, 2013 at 12:00 AM

   Hello. I had unprotected sex on September 3rd and I’m very concerned about possibly contracting HSV 2. I tested 13 weeks after on December 3rd and everything came back negative. Here are my HSV 2 results.

   Herpes Simplex Virus Type II
   Value: <0.91
   Range: 0.00-0.90
   Result: Negative
   Test Date: 12/03/2013
   Result Date: 12/05/2013

   What are the chances of a false negative?

   • Jenelle Marie

     December 14, 2013 at 2:41 PM

     Hi Daniel –

     Although the gold standard for herpes diagnosis is to do a viral culture or nucleic acid amplification test (NAT) from a visible sore, it is possible to screen for asymptomatic herpes infections using a blood test. The reason that viral culture and NAT are the gold standard for herpes testing is that these tests look directly for the herpes virus. There is, therefore, a relatively low risk of false diagnosis, which can be a serious concern with a disease as highly stigmatized as genital herpes.

     In contrast, herpes blood tests look for antibodies to the herpes virus, and there is some possibility that these tests may detect antibodies to similar viruses that are cross-reacting to the tests or that the threshold doesn’t recognize a new infection or a low-prevalence of infection. The risk of getting a false positive is related to the specificity of the particular herpes blood test being used and also to the prevalence of herpes in the population getting tested.

     No test is perfect. It’s always possible for a test to give inaccurate results, and the accuracy of a herpes blood test correlates with which specific test was used. The sensitivity/specificity of two different relatively standard Herpes blood tests are as follows:

     ELISA:
     ~91% sensitivity and 92% specificity for HSV1
     ~96% sensitivity and 97% specificity for HSV2

     Immunoblot:
     ~99% sensitivity and 95% specificity for HSV1
     ~97% sensitivity and 98% specificity for HSV2

     If you make the reasonable assumption that around 50% of the population are infected with HSV1, the virus primarily associated with oral herpes and cold sores, and 25% are infected with HSV2, the virus primarily associated with genital herpes, then the positive predictive value and negative predictive value are as follows:

     ELISA:
     HSV1: Approximately 92% of positive tests give the correct result.
     HSV2: Approximately 92% of positive tests are correct, and 98% of negative tests are correct.
     Immunoblot:
     HSV1: Approximately 95% of positive and 99% of negative tests are correct.
     HSV2: Approximately 94% of positive and 99% of negative tests are correct.

     In summary, the herpes blood tests are actually pretty good when done within the highest accuracy testing range! In a relatively high prevalence population, they give accurate results the vast majority of the time. It’s worth noting, though, that if my prevalence estimates were off and we worked from the assumption that only 10% of the population is infected with either virus, then although almost all negative tests would still be accurate, positive tests would only be correct 55% to 85% of the time.

     And, of course, you can always test again to be sure. 🙂

     Thanks for your question!

     • Daniel

       December 17, 2013 at 5:42 PM

       Thank you for your response. So chances are that I’m likely negative, since I tested at 13 weeks (3 months) ? However. I will do another 8 panel test again in another 3 months to be 100% sure.

       • Jenelle Marie

         December 17, 2013 at 8:10 PM

         No problem. Yup – odds are, your negative results were accurate, but, yes, you could always do another test again 3 months from the 1st test date to be really sure.

3. Peter

   December 15, 2013 at 2:31 PM

   best thing to do is having sex with tested people. testing only serves to ease your curiosity – unless you have symptoms. however if you do, I guess it’s too late. prevention is better.

   • Jenelle Marie

     December 16, 2013 at 3:20 PM

     Thanks for your comment!

     We like to take that a step further too; we advise partners to get tested together before engaging in activities with one another, using barriers for the first 3 months, and then getting tested together again, as this ensures any recent exposures get detected in either the first or second test.

4. Kay

   January 8, 2014 at 2:07 PM

   Just a quick thank you. Love your site and the completeness of the information and your answers.

   Broaching this topic in the 40 something dating world is important. After having an ex who took liberties with my health choices, and the resulting panic that I experienced, I might be a little on the extreme side with testing partners. HSV is not a deal breaker. It does, however, necessitate a greater commitment level, and it needs to be managed if one partner carries it.

   • Jenelle Marie

     January 8, 2014 at 5:23 PM

     Hi Kay –

     Thanks for your message. You’re welcome.

     Yes, it’s so important in the 40-something and above dating realm, and it’s often overlooked as an issue only 20-somethings need to worry about. Keep in mind, too, you only seem to be on the extreme side, because people aren’t testing as often or being as conscientious as they should. I’d like to see that paradigm shift – the ones who aren’t asking and don’t have a comprehensive understanding of their risks become the odd ones.

     Thanks so much for your comment!

5. Troubled

   January 16, 2014 at 8:43 PM

   Hi Jenelle, thanks for the excellent work you are doing here.

   I have done Herpes I and II IgG blood test at 9+ weeks post possible exposure and the results negative for both. How conclusive are the results?

   I have also done a 4th gen Duo/Combo fingerprick HIV test at 4+ weeks and 6+ weeks post possible exposure and both tests came back negative. Are the results conclusive?

   • Jenelle Marie

     January 18, 2014 at 11:41 AM

     Hi Troubled –

     The herpes test you took falls within the highest accuracy category, but the HIV test would need to be taken at 12 weeks for the same to apply. Most HIV specialists consider the test you took to be conclusive at 6 weeks, however, official HIV guidelines still recommend re-testing at 12 weeks for completely conclusive results.

     We always advise that after exposure, one should wait to test until the most likely to detect or highest accuracy category is fulfilled, and then they should test again 3 months later to ensure there weren’t any false-negatives.

     Thanks for your questions!

6. Concerned

   January 26, 2014 at 1:24 PM

   Hi Janelle,
   thanks for providing such clarity on this topic. My question is regarding the STD window periods.
   I am assuming that the window periods for “Possible Detection”, “Most Likely” and “Highly Accurate” are all stated as any period after the minimum time stated. Let me explain my question more clearly through an example.

   Say I engaged in sexual activity on Day 1 and I am concerned about having contracted Syphilis and Gonorrhea. Then, as per your chart if I want to go in for testing only once (for both Gonorrhea and Syphilis) then I can go any time after 12 weeks and in that case I would still be in the “Highly Accurate” testing window for both Gonorrhea and Syphilis (assuming of course that I don’t engage in any new sexual activity till this time of testing). What I’m trying to get at is whether the “Highly Accurate” Window has an expiry date at all or is it just any time after the time stated?

   Thanks for this great resource!

   • Jenelle Marie

     January 26, 2014 at 8:31 PM

     Hi Concerned –

     You’re welcome! Thanks for the example. Your assumption is correct; there is no expiry date. So, if you’re planning to get tested for more than one STD, and you would prefer to be tested only once, pick the highest accuracy category and get tested at the latest date among the STDs listed. (In the case of your example, specifically, any time after 12 weeks.)

     Great question!

7. Scared

   January 28, 2014 at 1:58 PM

   Hi Jenelle,
   Thanks for this extremely helpful resource. My question pertains to the testing window for HSV 1/2. I have been relentlessly scouring the web for info on HSV 1/2 blood tests, and most of what I have found recommends waiting 12 – 16 weeks for highest accuracy (some even go as far as to say any test prior to this is essentially garbage!). You indicate 6 – 12 weeks for highest accuracy, so I am confused! I tested negative for both HSV 1 and 2 at 6 weeks post possible exposure by IGg, and I plan to retest at 12 weeks but the waiting is killing me!! I was hoping you could help put my mind at ease about the accuracy of my negative test at 6 weeks. Thanks SO much for your help!

   • Jenelle Marie

     January 30, 2014 at 4:19 PM

     Hi Scared –

     Great observation. ASHA has recently updated their suggested windows, so we’ve followed suit. However, I wouldn’t go as far as to say that any tests taken prior to the highest accuracy category are garbage, rather, one is just more likely to receive a false-negative before that time. For some, that uncertainly means the test is wasteful, and they’d just assume wait. That decision has to be up to the individual and their testing provider. To assure your test was negative, though, I’d wait to retest until at least 16 weeks have passed, despite how waiting to verify your results is totally stressful.

     The other component I would consider when worrying about your test’s accuracy is what type of test you took. This reference guide talks about the different tests used in blood testing for HSV, and it provides web addresses to do some research on sensitivity.

     Thank YOU for a great question!

8. Worry wart

   February 22, 2014 at 1:48 PM

   Jenelle,
   First I want to say thank you for your information. As several have posted ur time frames are very straight forward . I requested std testing through my gyn 3 months post possible exposure. I was having discharge and instead of swabbing me the P.A. just used a gloved finger to collect discharge and put it into a specimen container and sent it off. Results showed negative for gonerhha,chlamdia, etc and just positive for yeast. Is the way she took the sample correct and are my results accurate
   Thanks

   • Jenelle Marie

     February 22, 2014 at 4:48 PM

     Hi Worry wart –

     You’re right to be a little bit taken aback by their procedural technique. While I wouldn’t say the PA’s collection method was inaccurate, it was also not the most professional. The results might have been the same regardless – I can’t say for sure without knowing what a second swabbing found – but an actual swab would have been more thorough and would definitely provide a more comprehensive result.

     So, it’s never a bad idea to get a second opinion and to have another professional do the procedure just to be sure and because the previous clinician was a bit careless in their approach. You can probably get testing done again for free or for a very low cost.

     Thanks for your question!

9. RJ

   March 31, 2014 at 2:51 AM

   Hello,

   I have a question, my partner was tested and came out positive for Chlamydia. I got tested right away, which the earliest I would have contracted the disease would have been 3 1/2 weeks before testing. The test came out negative, but me and my partner had unprotected sex multiple times. I still have the worry that I may still have the disease, when should I get tested again? After I found out results were negative, we didn’t have sex again until her 2 weeks after medication were up.

   • Jenelle Marie

     March 31, 2014 at 10:23 AM

     Hi RJ –

     To make sure, you’ll want to get tested one more time at the highest accuracy point after the last time you had sex before you stopped while she was under treatment.

     Keep in mind, it’s also possible that you didn’t contract the infection – especially if you’re a male, because men are less susceptible to a lot of sexually transmitted infections. But it never hurts to be certain and to get another test done as well.

     Thanks for your question!