My Doctor Won't Test Me for Herpes, Now What?

Earlier this year, I wrote a post entitled, “Where In the World Can I Get Tested for Herpes?” The post was inspired by an overwhelming number of messages that inquired about types of testing, availability, and access across the globe. After further exploration into countries ranging from Australia, to Canada, to New Zealand, and India, it became increasingly clear that available testing does not translate to accessible testing.

Screening vs. Diagnosing: What’s the Difference
Screening
tests are performed on individuals who are considered as high risk for sexually transmitted infections, but do not have symptoms (Medical Institute for Sexual Health). Diagnostic tests are used in individuals who present with signs and symptoms of sexually transmitted infections (Medical Institute for Sexual Health). Screening and diagnostic tests may be the same for some infections, but not all. For example, if lesions are present, PCR testing will be used as a diagnostic test. This method cannot be utilized on an individual who does not present with symptoms.

CDC Herpes Screening Guidelines and Recommendations  
In the United States, the Centers for Disease Control and Prevention (CDC) does not recommend screening for individuals who do not present with symptoms of genital herpes. While guidelines across the globe vary (and several can be found within this post), the CDC does not currently recommend screening because:

  1. diagnosing someone without symptoms (asymptomatic) has not proven to change sexual behavior (i.e. safe sex practices);

  2. false positive testing is possible; and

  3. the negative psychosocial impact of the diagnosis can be substantial even in asymptomatic individuals.

Although the guidelines seem to discourage testing in asymptomatic individuals, the CDC offers possible circumstances in which practitioners may test for genital herpes because it “might be useful” (CDC).  These circumstances include:

  1. presenting symptoms on the genitals that may be related to herpes;

  2. engaging in sexual behaviors with a discordant, HSV+ partner (meaning that this
    partner tests positive for herpes, and you do not).

  3. if you have multiple sex partners and desire a complete panel.   

These scenarios are in existence, but not necessarily in practice. From conversations with friends and inquiries online, it appears that it is not as simple as telling a doctor that you engage in sexual behaviors with multiple partners or have recently broken off a relationship with a partner who had genital herpes and that you’re looking to know your own status. Even a desire to know one’s own status, which is encouraged in comprehensive sexuality education programs, is often disregarded and dismissed by practitioners as unnecessary per mandated guidelines.

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So What Do You Do?
No matter how prepared you are when you arrive to your appointment, and how certain you are in your right to be screened (which, for the record, is both your right and responsibility), you may still be declined by your healthcare professional. Leaving the doctor’s office defeated, hopeless, and confused, there are still viable options for testing. STDcheck.com, a HealthLabs.com company, offers accessible testing panels and individual tests that can be purchased online and taken at one of their 4,500 testing centers across the United States.

How Does It Work?
STDcheck.com is HIPAA compliant, BBB accredited A+, offers FDA-approved tests, and hosts CLIA-certified labs (govern all clinical lab testing facilities within the U.S.). Their 10-Test Panel includes HSV-1, HSV-2, HIV Type 1, HIV Type 2, Hepatitis A, Hepatitis B, Hepatitis C, Gonorrhea, Chlamydia, and Syphilis at a cost of $198. If you are looking to screen for a more specific infection, like genital herpes, you can purchase blood tests for HSV-1 and HSV-2 for $65 each, or $130 combined. It should be noted that it may take significant time for antibodies to develop to the virus (3 weeks to 6 months), so if you are tested within days of exposure, your results may still be negative.

IgG typed tests are the most accurate blood test when screening for herpes and can break strains down by HSV-1 or HSV-2 antibodies (ASHA). IgM typed tests, another available herpes testing method, are not recommended based on false positives, cross-reactions, and inability/inaccurate typing. STDcheck.com offers type-specific enzyme-linked immunosorbent assays (ELISA) that seek out IgG antibodies to the herpes simplex virus, the most accurate testing method. After submitting payment for your test, you will be prompted to enter your zip code to find and choose a convenient testing center. STDcheck.com will send a lab requisition form and test code for you to bring along to your appointment. Your results will be available to you within two business days and you will have the option to consult with a physician to explain your results, offer guidance, answer questions, and offer potential treatment.

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Accessibility
STDcheck.com offers multiple payment methods which include credit cards, cashiers checks, flexible spending accounts, health savings accounts, and cryptocurrency. Health insurance is not accepted in order to ensure patient privacy.

STDcheck.com: A Solution?

While I believe that advertising a private environment for screening and diagnosing sexually transmitted infections further promotes the idea of shame and perceived stigma (i.e. something secretive), I do believe that there is great purpose in the ability to advocate on behalf of our sexual health. This certainly is not the only solution for screening, but it is comforting to know that additional options are available to us at our discretion if they are within our means.

Additional Resources
How to Advocate for Your Sexual Health at the Doctor’s Office
Herpes Testing (ASHA)

[This is a sponsored post for STDcheck.com]