It can be hard to tell if you have a sexually transmitted infection (STI), many do not always show symptoms. Often, people who pass an STI to a sexual partner do not know that they have an infection. The only way to know whether or not you have an STI is to get tested.
Symptoms of an STI may include:
- Discharge from penis
- Changes in vaginal discharge
- Bumps, sores or a rash on the genital area (penis, vagina or anus)
- Blood in the urine
- Burning or unusual feeling when urinating
- Pain in the pelvis or testicles
- Pain during sexual activity and intercourse
If you or your sexual partners have any of these symptoms, it is recommended to see a health care provider. Getting tested for STIs in British Columbia (BC) is confidential, easy, and usually free. Untreated STIs can lead to serious problems like pelvic inflammatory disease or epididymitis. Having an STI also increases the possibility of getting HIV.
When you have an STI but there are no symptoms, this is called being ‘asymptomatic’. Even with no symptoms, a person can still pass on an STI. If you think you might have an STI but are not showing symptoms, make sure to tell your health care provider why you think you need to get tested.
Looking up symptoms on the Internet
The internet can be a good source of information about sexual health and STIs, but trying to figure out if you have an STI from the internet can be a problem. Pictures typically show STIs in an acute phase with very obvious symptoms. Your symptoms may not be visible or may be similar to other problems that need different treatments.
Sometimes looking up information on the internet can increase your anxiety. This may be a sign you have information overload. If you are not getting any answers and are worried, see a health care provider
Testing & Getting Results
When to test
It’s a good time to get tested for STIs when:
- You have a new sexual partner(s).
- You or your partners have other sexual partners and it’s been more than three to six months since your last test.
- You notice any changes in your body, or have symptoms.
- You had sex with someone who has an STI.
- You had sex without a condom or the condom broke.
It’s a good idea to get tested for STIs regularly, usually every 3 – 12 months. For example, if you or your partner(s) are having sex with new or casual partners, you might want to test every 3 or 6 months. It is not usually recommended to test more often than every 3 months (ie. monthly).
It takes time before an STI infection will show up on a test. This is called the “window period”.
The window period is the time between when a person comes in contact with an STI and when the STI will show up on a test.
It is important to consider the window period when getting tested. Tests done too early may not be accurate. The time will vary from a few days to six months depending on the infection and the test. You can pass on an STI during the window period.
If you want to be tested because of a specific sexual contact you had, we recommend testing at 3 weeks and 3 months following contact. At 3 weeks, most tests should detect an infection, and at 3 months most are considered accurate.
Find out the window periods for different STIs.
Tests & exams
Testing for STIs can be done at a public health unit, health clinic or doctor’s office. A visit may take between 15 to 45 minutes, depending on the clinic and what tests you need. It may be helpful to bring a checklist to talk with your health care provider about what tests you might need.
A few questions first
To decide what exams or tests you might need, the health care provider will ask you questions about your sexual health history. To get the best care, it helps to be as honest as you can. Ask questions if you need more information.
In BC, some sexual health clinics will allow you to choose to use your real name and identifiers (nominal testing), or a pseudonym using a fake name or without full identifiers such as personal health number (non-nominal testing).
STI and HIV testing is always confidential, which means your health information is private.
What tests are usually done
STI testing is done by taking swabs and collecting body fluids, which are sent to the lab. Testing for HIV, syphilis and hepatitis is done with a blood sample. Testing for chlamydia and gonorrhea is done with a urine sample, and/or a swab of your genitals, throat and/or anus. If you have symptoms, other swabs, tests or exams may be recommended.
People who have a cervix may be offered a pelvic exam. During the pelvic exam, the health care provider takes swabs from the vagina and/or cervix to test for chlamydia and gonorrhea, and may also do a Pap test for cervical cancer screening.
Types of STI tests and exams that may be done:
Pelvic Exam: There are two parts to a pelvic exam.
- Speculum exam. A speculum is placed into the vagina and gently opened. Swabs are taken from the vagina or cervix and sent to the lab for STI testing.
- Bimanual exam. This is done to check your uterus (womb), fallopian tubes, and ovaries. The health care provider will place two gloved, lubricated fingers into your vagina, and will gently press on your lower belly with the other hand. You may feel pressure, but it shouldn’t be painful.
Urine tests: You will be asked to pass urine (pee) into a cup. The tests are most accurate if you have not passed urine for 1-2 hours before giving the urine sample.
Swab tests: Swab tests are done with a sterile swab (a small stick with a ball of absorbent material on the end) that is sent to the lab for testing. Swabs may be taken from the vagina, cervix, penis, throat, anus, or skin.
- Vaginal and cervical: A sterile swab is used to take a swab from the cervix or vagina. This test is done if you have had vaginal sex or notice changes such as increased fluid or a change in fluid from your vagina. A Pap test may be done at the same time.
- Urethral (penis): A swab is usually done when there is visible discharge from the penis. A sterile swab is used to take a sample from the discharge. This test is most accurate if you have not passed urine (peed) for 2 hours beforehand.
- Anal: A sterile swab is gently inserted into the anus and a sample is taken from the inside of the rectum. An anal swab is taken if you have had anal sex or notice changes such as pus, pain or bleeding from the rectum.
- Throat: A sterile swab is used to take a sample from the throat. A throat swab is taken if you have had oral sex or a sore throat.
Blood tests: Both syphilis and HIV testing are done on blood samples. HIV testing is done in two ways.
- Antibody/Antigen testing: A blood sample will be taken from your arm in the clinic or you may be sent to a lab to have your blood drawn.
- Rapid test or point of care (POC) testing: This test is being used in many areas of BC for HIV testing. Check with your local clinic to see if it is available. This test is done with a small drop of blood taken from a finger prick. The results are available in 60 seconds. If the Rapid test shows that you have HIV antibodies, then a second blood test is done to confirm whether the result is truly positive. The second blood sample is taken from your arm and sent to a lab for testing.
Waiting for results
Most STI test results come back from the lab within seven to ten days. When you get tested, talk with your health care provider about how you will get your results. Find out if you can call in, or need to return for your test results. If you cannot be contacted by phone, talk with your health care provider about how you will get your results.
If you have symptoms or are taking treatment, it is important to avoid any sexual contact until you and your partners have finished the treatment. Ask your health care provider about when it is OK to have sex.
If your test results are negative
If you get a negative test result, it means that the tests did not find an STI.
Each STI has a ‘window period’. This is the time between when a person comes in contact with an STI, and when the STI will show up on a test. If the test is taken too soon after contact there is a chance that a test result is not accurate. You may be asked to come back to be retested after the window period is over.
If your test results are positive
If you get a positive test result, it means that you have an STI and need treatment.
In BC, positive test results for reportable STIs are shared with public health to ensure that you and your partners are offered support and treatment.
In BC, syphilis, gonorrhea, chlamydia and HIV are examples of reportable infections. When lab tests for these sexually transmitted infections (STIs) are positive, these results are reported to the local medical health officer to help prevent the spread of communicable infections. This information is stored securely to keep it confidential.
When you are diagnosed with a reportable STI, anyone you have had sexual contact with or shared drug equipment with needs to be notified that they have been exposed to a communicable infection. This is called ‘contact tracing’ or ‘partner notification’. It is important that partners who may also have the infection get treated so that they do not pass it to others or pass it back to you, and to reduce the chance of longer-term health problems.
A health care provider (such as your doctor or a public health nurse) will ask about past and present sexual partners, and anyone you have shared drug equipment with. The health care provider will then develop a plan with you on how to notify these sexual partners and/or drug contacts. They can also help you decide the best way to let partners know they need to get tested.
Partners can be told by you, a health care provider, or anonymously. You can talk with your health care provider about who should be informed and what is the best way to let them know.
If you choose to ask a health care provider to contact your partners, your name or other personal information will not be used. The health care provider will tell the person they may have an STI and encourage them to come in for testing and treatment.
Confidentiality & how your information is protected
Any information shared with a health care provider is confidential, including test results. When you go for STI testing, you may be asked for personal information such as your name, birth date, Medical Services Plan (BC Care Card) number, contact information (like phone number, address and email) and health history. This information is used to give the best health care, order tests and to contact you about the results.
All the health authorities in BC and the BC Centre for Disease Control (BCCDC) are governed by privacy laws. Privacy and data security are important and are taken very seriously. Personal information is kept secure and is not accessible to the public. For more information, please see the Office of the Privacy Commissioner of BC.
Where is STI testing information stored?
All test results: Any electronic or paper records of negative and positive test results are kept at your health care provider’s office.
Information about lab tests is routinely stored in laboratory databases where the specimens are process or tested. In BC, lab results are also kept in a provincial laboratory system called the Provincial Laboratory Information System (PLIS). The purpose of this electronic health (e-health) record is so that your health care provider will be able to see relevant parts of your health care record.
For more information about e-health systems in BC including PLIS, and more options for controlling access to your health information in these systems, please visit eHealth, Ministry of Health.
Positive test results: In BC, the Communicable Disease Regulation of the Public Health Act legally requires a lab and/or a physician to report any case of infectious disease, including some sexually transmitted infections (STIs), to the Medical Health Officer (MHO) of the appropriate health authority. This reporting is done so that public health nurses can offer support to a person with a new diagnosis, ensure the notification and testing of partners and monitor the number of new infections. These results are kept in provincial and regional health authority electronic information systems.
In BC, STIs that must be reported include:
- Hepatitis A, B and C
Within these databases, access to information is based on the health care provider’s role and whether they need the information in order to provide care or to carry out their legislated functions under the Public Health Act.
Contacting partners about testing
If you have a reportable STI, your health care provider will talk with you about how you want to tell your sexual partners. The purpose is to get people tested and treated and to stop the STI from being passed on to other partners.
Youth and Confidentiality
If you are under the age of 19, you can get confidential health care if a health care provider considers you old enough to make your own decisions about your health. This means your health care provider must keep your information private. They cannot contact your parents or guardians without your permission.
There are some exceptions to confidentiality for youth. If you, or any other youth under 19, are being harmed or are at risk of harm, the health care provider is required by law to report it to the proper authorities. This law is meant to help keep youth and children safe from abuse.
Many youth choose to go to youth clinics. These clinics offer free STI testing to youth – many youth clinics service people under the age of 24, but call the youth clinic nearest to you to find out the age cut-off.