Hey folks, Dr. Tom here, coming at you with info on STI screening for men who have sex with men. It’s a hot topic, and one that deserves some "straight" talk—especially when quotes like “I was tested for everything” keep popping up. Let’s break down what screening really means, which infections are typically checked, and why “everything” is simply not on the menu.
How Often Should You Get Screened?
For those of you who are sexually active—and especially if you're on PrEP—the recommendation is to get tested every 3 months. This schedule isn’t just about early detection; for patients on PrEP, regular testing is essential to help prevent the generation of resistant HIV strains. By catching any potential HIV exposure early, healthcare providers can take swift action, ensuring that your PrEP remains effective and that any necessary interventions are implemented without delay.
What’s on the Testing Menu?
When you head in for your screening, you’ll typically be tested for a handful of common infections. Here’s what that often includes:
- HIV: The cornerstone of STI screening. Testing methods vary, from rapid tests to lab-based blood work.
- Syphilis: Usually done with a blood test that can catch the infection early—although it may not detect syphilis in its very earliest "primary" stage. That’s why it’s crucial to let your doctor know if you’ve ever had a painless sore anywhere on your body or in your mouth.
- Gonorrhea and Chlamydia: These bacteria can infect multiple areas. Testing often involves urine tests, as well as swabs from the throat and rectum if those sites are exposed. If your screening doesn’t include throat and ass swabs, you could be carrying chlamydia or gonorrhea without even knowing it—so don’t hesitate to ask your provider about comprehensive site-specific testing.
- Hepatitis (B and C): These viral infections may be screened for based on your risk factors or symptoms.
It’s key to understand that while these are standard tests, the idea of “being tested for everything” is a myth. Clinics focus on the most common and high-risk infections because there are hundreds of microbes that could theoretically be screened. The panels are designed to target tests that matter most for your health.
Testing Isn’t a “One-Size-Fits-All”
Many people proudly claim, “I was tested for everything,” but the reality is more nuanced. Clinics follow guidelines that prioritize infections with the highest prevalence and risk. There’s no universal panel that includes every single STI out there—nor should there be. It’s all about targeting the tests that make the most impact on your well-being.
Spotlight on Mycoplasma Genitalium (MG)
One case in point is Mycoplasma genitalium (MG). This STI is a bit of a newcomer to the mainstream testing world. We’ve only recently developed reliable tests for MG, and it isn’t routinely screened for in asymptomatic people. While MG can cause symptoms like urethritis (inflammation of the urethra), it often flies under the radar. Because of its relative novelty in testing protocols and the lack of widespread routine screening, many people might not even be aware of it. This example highlights that not every potential infection is part of the standard screening battery.
What Does the Testing Process Look Like?
Typically, your STI screening visit will include:
- A Detailed Health History: Your provider will ask about your sexual practices and any symptoms you might be experiencing.
- Physical Examination: Sometimes, a brief physical exam is needed, especially if there are symptoms.
- Sample Collection: This can include blood samples, urine tests, and swabs from different anatomical sites (such as the throat, rectum, or genital area). If your screening doesn’t routinely include throat and ass swabs, be proactive—ask your provider about them, as these are essential to detect infections like chlamydia or gonorrhea.
- Follow-Up: Depending on your results, you might be asked to come back for additional testing or treatment.
The process is designed to be as non-invasive and comfortable as possible while still giving a clear picture of your sexual health.
The Takeaway
Regular STI screening every 3 months is a key part of maintaining your sexual health, especially for men who have sex with men and those on PrEP. This frequent testing not only ensures early detection of infections and helps prevent resistant HIV strains but also keeps you informed about infections like syphilis, which might not be detected in its primary stage. If you’ve ever had a painless sore anywhere on your body or in your mouth, make sure to mention it to your doctor. And if your screening doesn’t include swabs from the throat and rectum, ask about it—missing these could mean unknowingly carrying chlamydia or gonorrhea.
Stick to these guidelines, understand which infections are being screened for, and don’t buy into the myth that “everything” is being checked when it isn’t. With the evolving landscape of sexual health—like the newer testing for MG—it’s vital to have informed conversations with your healthcare provider about which tests are right for you.
Stay safe, stay informed, and until next time—keep it real in P-Town and everywhere else!
Tom of P-Town
Your go-to guide for no-nonsense sexual health advice
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