What Test Do I Need? A Test Guide by Symptoms and Situations

When you’re dealing with a scary symptom or are contemplating a “was that risky?” moment, the best thing you can do for yourself is shed the shame and treat the issue. For some, the hardest part can be knowing what to test for and when. Use this quick test guide by symptoms and situations to choose the right tests, understand timing (window periods), and know when urgent action like HIV PEP or DoxyPEP makes sense.

It’s important to note that many STIs have no symptoms. If you’re sexually active, especially with new or multiple partners, test every 3–6 months, or anytime you have a new partner or a condomless encounter.

Fast Track: When Timing Is Urgent

Possible HIV exposure in the last 72 hours?
Ask about HIV PEP immediately. It’s a 28-day medication course that can prevent infection if started ASAP (within 72 hours).

Condomless sex with (AMAB) partners and you’re eligible for DoxyPEP?
Consider Doxycycline Post-Exposure Prophylaxis within 24 hours (up to 72 hours) to lower the risk of chlamydia & syphilis (and possibly gonorrhea).

Window Period Cheat Sheet 

  • HIV (4th-gen blood test): detectable from ~18–45 days after exposure (though some positives can show up earlier).
  • Chlamydia/Gonorrhea (NAAT): 5–7 days after exposure for most, optimal ~2 weeks.
  • Syphilis (blood test): many positives by 3–6 weeks; retest at 6–12 weeks if suspicion remains.
  • Herpes (swab of a fresh sore): immediately when lesions appear; blood tests are situational.

(If you test early, plan a follow-up test after the window period.)

If You Have Symptoms: What to Test For

Unusual discharge (penile, vaginal), burning with urination

  • Test: Chlamydia & Gonorrhea NAAT (urine or vaginal swab), Trichomonas (if vaginal symptoms), Syphilis blood test if lesions/rash.
  • Consider: Site-specific swabs (throat/rectal) if those sites were exposed.
  • Timing: Test now; repeat at 2 weeks if early after exposure.

Genital sores, blisters, or ulcers

  • Test: HSV swab (from a new sore ASAP), Syphilis blood test.
  • Tip: Come in as soon as a sore appears, as swabs are most accurate on fresh lesions.

Genital itching, irritation, or odor (vaginal)

  • Test: Chlamydia/Gonorrhea NAAT, Trichomonas test, consider yeast/BV evaluation.
  • Note: Yeast/BV aren’t STIs but can co-occur. Testing helps sort it out.

Sore throat after oral sex

  • Test: Throat swab NAAT for Gonorrhea and Chlamydia (urine alone can miss these).
  • Timing: 5–7 days post-exposure or when symptoms start.

Rectal pain, bleeding, discharge after receptive anal sex

  • Test: Rectal swab NAAT for Gonorrhea and Chlamydia, Syphilis blood test if rash/sores.
  • Timing: 5–7 days post-exposure or with symptoms.

New widespread rash, especially on palms/soles, or unexplained fever

  • Test: Syphilis blood test; discuss HIV testing.
  • Timing: Test now; plan repeat at 6–12 weeks if recently exposed.

Flu-like illness 2–6 weeks after a high-risk exposure

  • Test: HIV (rapid + 4th-gen lab test), and Syphilis if rash/sores.
  • Note: This could be acute HIV; seek testing now.

If You Had a Specific Encounter

Condomless vaginal or anal sex (or condom broke)

  • Now: Chlamydia/Gonorrhea NAAT (urine or vaginal swab) + site-specific swabs (throat/rectal if exposed), Syphilis blood test baseline, HIV rapid.
  • Follow-up: Repeat Chlamydia/Gonorrhea at 2 weeks; Syphilis/HIV at 6–12 weeks.
  • Consider: DoxyPEP within 24–72 hours (if eligible), HIV PEP within 72 hours if risk is significant.

Oral sex without barriers

  • Now: Throat swab NAAT for Gonorrhea/Chlamydia if symptoms or high risk.
  • Follow-up: Consider repeating at 2 weeks post-exposure if the initial test was very early.

New or multiple partners in the last 3–6 months

  • Panel: HIV (4th-gen), Syphilis, Chlamydia/Gonorrhea NAAT (urine or vaginal), plus throat/rectal swabs if those sites were used.
  • Routine: Every 3–6 months going forward.

Sex while intoxicated or unsure what happened (see Sexual Assault below)

  • Now: Baseline HIV, Syphilis, Chlamydia/Gonorrhea NAAT (urine/vaginal + site-specific).
  • Urgent: If possible, HIV exposure within 72 hours, seek PEP immediately.
  • Follow-up: Retest per the window periods above.

Sexual assault

  • Urgent: Medical care ASAP. Ask about HIV PEP, emergency contraception (if relevant), forensic exam options, and STI prophylaxis.
  • Testing: Baseline panel now; follow-up per clinician guidance.

Don’t Forget Site-Specific Testing

Urine-only screens can miss infections in the throat or rectum. If you have oral or anal sex, ask for:

  • Throat swab NAAT for Gonorrhea/Chlamydia
  • Rectal swab NAAT for Gonorrhea/Chlamydia
    (We can guide self-swabs if you prefer.)

Prevention You Can Start Today

  • Condoms (external/internal) + lube to reduce tears and STI risk.
  • PrEP (pill or long-acting shot) for ongoing HIV prevention.
  • DoxyPEP within 24–72 hours after condomless sex (if eligible) for bacterial STI risk reduction.
  • Regular testing cadence: annually at minimum; every 3–6 months with new/multiple partners.

How Health Stop STL Can Help

  • Free & confidential STI/HIV testing (walk-ins welcome)
  • Throat/rectal/genital testing based on your exposure
  • Rapid HIV and follow-up scheduling for window periods
  • PrEP/PEP consults and DoxyPEP guidance
  • Free condoms and at-home test kits (fast, discreet shipping)
  • No ID or insurance required, affirming care for all genders

Not sure what to ask for? Just tell us what happened or what you’re feeling. We’ll help you choose the right tests and timing, judgment-free.

Ready to get answers? Visit Health Stop STL today for quick, confidential care.

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