I posted in the past saying I wouldn’t contribute to these STI threads anymore because of the amount of ignorance/bad advice/paranoia etc they contain. However as Tailseeker who used to give good knowledgeable and balanced input seems to have disappeared? I feel the need to chip in again.
Re the swabs. Urine tests have improved in accuracy over the last decade and are now the first choice method
for asymtomatic men for gonorrhoea/chlamydia (but not women where swabs are still required) However urethral swabs may still be taken for men if symptoms are present, as unlike the urine test it can determine which is the most effective antibiotic regime to prescribe especially in cases of antibiotic resistance. The urethral swabs are small and are inserted only about 2 or 3 cms into the urethra. Maybe slightly uncomfortable for some at worst and not a big issue, but psychologically many men have always struggled irrationally with japs eye insertions. That is why the urine test development in accuracy has the advantage. The tests are more expensive than the swabs though and for 100% accuracy you should not have had a pee for at least two hours prior to the sample being taken.
Regarding the OP question ... firstly anyone with any symptoms must get tested at the earliest opportunity. With regard to screening it is much less clear cut. We know many STIs are symptomless and with a professional hat on I should therefore say yes it is important. But is there any actual real benefit in doing so? Firstly the reality is that most punters do not get tested regularly. (I won't even begin to discuss SPs where uptake is also dubious?)
People are quoting every 3 months or 6 months etc but there is no one size fits all. The starting point will depend entirely on your sexual history/activity and whether you fall into a truly high risk group? Ethnicity should also be considered. The vast majority of punters will not as they are having protected penetrative sex with women only. On that note it disturbs me that people are lying about having sex with men etc in order to have totally unnecessary tests carried out. Waste of resources for an NHS system under strain and with its GUM budget cut back.
The numbers of people attending UK STI clinics has risen by I think about a third over the last 5+ years. Some will have symptoms to partly account for the increase but some will just be for screening and yet the rate of STIs (apart from HIV) has also increased over that same period. This calls into question the role of screening tests and their true effectiveness.
In the US the same has happened but on a much larger scale and the CDC has now drawn up a protocol for priority testing. This is an attempt to best use limited resources more effectively on what is a serious public health issue. As a result this no longer includes asymptomatic heterosexual males who are sexually active although each case will be judged individually. The high risk groups are now restricted to MSM and under 25s or pregnant females. (the under 25s account for the vast majority of cases of chlamydia and also with the highest rate of increase). Females are considered higher risk because gonorrhoea and chlamydia are potentially more harmful to them than males.
External Link/Members OnlySo as I said with my professional hat on I should encourage punters to get tested and if no symptoms and no incidents (eg condom breakage) 12 months is a likely to be suitable for most and even that is probably not necessary for a significant number whose sexual history does not warrant it?
If however you consider best use of limited NHS resources to tackle a health problem which the current system is failing to control then it is a whole different debate?
