STD screening

Screening for sexually transmitted diseases (hereinafter referred to as STDs) is by no means the so-called "exclusive examination for unruly people". All people who have had unprotected sex, had multiple sexual partners, had a history of infection in their sexual partners, or have suspected symptoms such as genital itching/ulcers/abnormal discharge, should proactively undergo targeted screening. Regular and standardized screening is the most efficient way to block the hidden spread of STDs and avoid serious consequences such as long-term infertility and organ damage. **

Last Wednesday, I just received a 22-year-old girl from the dermatology clinic. She suffered from itching in the lower body and purulent discharge for 2 weeks. I bought gynecological lotion and suppository at the drugstore, but it had no effect at all. I came to the doctor nervously and asked her if she had had unprotected sex. I nodded with a red face. Finally, it was found that she was positive for Chlamydia trachomatis, and she was also infected with HPV16. When asked why she hadn't thought of doing the screening before, the little girl lowered her head and said, "I thought only people who mess around need to be screened for this." I have encountered this kind of misunderstanding too much in the outpatient clinic. Many people stigmatize STD screening, which is more harmful than the disease itself.

Regarding the frequency of screening, there are actually significant differences in the recommendations of different institutions: the US CDC guidelines recommend that all sexually active people under the age of 25 should be screened for gonorrhea and chlamydia every year, and men who have sex with men should be screened for syphilis, HIV, and perianal gonorrhea every 3-6 months.； The consensus of the my country Centers for Disease Control and Prevention and the clinical expert group is more individualized - if you have a fixed single-sex partner, use condoms correctly every time you have sex, and do not have any suspected symptoms, it is actually not necessary to do a full set of screenings every year. It can be done incidentally during a routine gynecological/andrological examination every 2-3 years. Over-screening is unnecessary and will increase unnecessary financial and psychological burdens. If you really want to argue that "it's always right to check more," then in fact no one can stop you from checking ten times a year, but ordinary healthy people really can't afford to worry about spending extra money for an almost zero probability.

If you really want to go for screening, you don’t have to order a “full luxury package” that costs thousands of dollars. You can choose based on your own situation: if you just had an accidental unprotected sex and don’t have any symptoms, just check for the four most common types of syphilis, HIV, gonorrhea, and chlamydia first. It can be done for a few hundred dollars.； If symptoms such as genital growths, ulcers, and unexplained pain have already occurred, targeted programs such as herpes simplex virus, HPV, and acetic acid whitening tests will be sufficient. I met a young man before and he told me that he wanted to be checked for all sexually transmitted diseases. When I asked him, I found out that it was the first time I was unprotected with my girlfriend, so there was no need to spend the money. Finally, I prescribed four basic tests for him, and the results were all positive, so I didn’t have to figure it out when I went back.

Oh, by the way, you don’t have to go to the hospital and queue up now. Centers for Disease Control and Prevention in various places have free anonymous HIV and syphilis screening sites. You can get test strips with your ID card. There are also many compliant medical platforms that also have self-test kits. The express delivery is private, and there is not even a word "medical" on the packaging. You can get the results at home in 15 minutes. But here is an important point: if the self-test is positive or suspected to be positive, you must not speculate at home. You must go to a regular hospital for a confirmatory test. After all, the self-test reagent has a certain probability of false positives. Don’t scare yourself, let alone ignore it and delay treatment.

Last month, there was a 32-year-old male patient who had been married for two years and was preparing to have a child. After a pre-pregnancy checkup, he was found to be positive for syphilis, which was in the second stage. I asked him if he had any suspicious exposure before, and he said that he had several unprotected one-night stands five or six years ago. After that, he didn't develop chancre or fever, so he didn't take it seriously at all. Now that he wants to have a child, he discovered the problem. Not only did he need contraceptive treatment first, but he also had to ask his wife to follow the investigation. After struggling for more than half a month, the two of them were in trouble and wanted to divorce. You said that even if you spent 200 yuan to check for syphilis a few years ago, how could it have come to this?

Many people are also worried about privacy issues. Don't worry, the test results of regular hospitals are strictly confidential. No one can get your report except the doctor and yourself. Even for notifiable infectious diseases such as AIDS and syphilis, only anonymous statistics will be used when reporting for disease control. Your personal information will never be leaked, and there is no need to fear social death.

In fact, to put it bluntly, STD screening is no different from your annual physical examination or Helicobacter pylori test. It is just an ordinary health management method. It is neither a "disgraceful proof" nor a scourge. You are responsible for your own body and the people around you. There is nothing to be embarrassed about.