Can I get an STD blood test or do I need a swab?

Technician holding blood sample
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Question: Can I get an STD blood test or do I need a swab?

There are a number of reasons why people worry about going for an STD test. They may be concerned about the stigma associated with STDs. They may be worried about talking to their partner about STDs. They may also be afraid that going in for STD testing will require scary embarrassing or uncomfortable swabs

Fortunately, that last worry is reasonably easy to deal with.

Thanks to significant improvements in testing technology, many STDs can be detected via an STD blood test or urine test. Urine tests are primarily used to detect chlamydia and gonorrhea, but there are a few more options for STD blood tests.

Answer: Commercial STD blood tests are widely available for the following sexually transmitted diseases.

  • Herpes: There are a number of herpes blood tests on the market, although their accuracy is somewhat variable.

    However, the biggest downside of herpes blood tests is that, since both HSV-1 and HSV-2 can infect either the mouth or the genitals, even the best type-specific herpes blood test will not tell you where you are infected in the absence of visible sores. They can only identify whether you are infected with HSV-1 or HSV-2.

    In addition, some doctors are reluctant to test for herpes in the absence of symptoms because of the stigma associated with a positive test. They think that what people don't know won't hurt them. However, the virus can be transmitted even when no symptoms are present, which can lead to some painful conversations when a newly infected person thinks they've been lied to by the person they love.
  • HIV: HIV is usually diagnosed through a blood test, although there are also oral tests that use saliva samples to test for the virus that causes AIDS.

    In general, it requires both a positive initial test and a positive confirmatory test for a person to be considered HIV-positive. However, the process of confirmatory testing is usually invisible since both tests are generally done on the same blood sample. When you get your results, it doesn't necessarily show what tests were done on your blood, just what the results were in combination
  • Syphilis: There are several different blood tests for syphilis. These can be used in combination to determine both whether you are currently infected as well as whether you have been infected in the past.
  • Hepatitis B: As with syphilis, there are multiple blood tests for Hepatitis, which can be used to determine your history of infection as well as whether you're currently infected with the virus.

If neither a urine nor a blood test is available for an STD, then it is usually identified by either visual or microscopic examination of sores or by some form of bacterial culture. These types of tests may also be used instead of, or in addition to, blood tests for the diseases listed above in certain situations.

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