Health

If You Ever Plan To Have Sex, Use This Guide To Get Tested For Free

Because knowing your status should be as easy as, well, peeing in a cup.

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Getting tested for sexually transmitted infections (STIs) is a great way to keep yourself and others healthy when you're sexually active.

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Getting tested is pretty much always a good idea — whether you just got into a new relationship with someone, you recently had unprotected sex, or you're just not totally sure what your status is.

Ideally, you should start getting tested after your first sexual encounter and then between partners in the future. STIs can be spread through oral, anal, and vaginal sex — and sometimes just through skin-to-skin genital contact or sharing sex toys. So if you're engaging in any of these sexual activities, it's probably time to think about getting tested — even if you think you and your partner are STI-free.

*FYI: Sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) essentially mean the same thing, though many experts choose to use the term STI since a disease is something that comes with a certain set of symptoms, and STIs are often symptomless.

Think an STI can never happen to someone like you? Well, STI rates are currently the highest they've ever been, and more than half of those infections occur in people under the age of 25.

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So, yeah, they're pretty damn common. According to the 2015 Surveillance Report from the CDC, STIs have reached an all-time high in the US, meaning the total combined cases of chlamydia, gonorrhea, and syphilis reported in 2015 reached the highest number ever.

Even though young people only make up a quarter of the sexually active population in the US, they account for more than half of the 20 million new STI infections each year.

But don't freak out. STIs are all treatable, and many of them are even curable with a simple dose of antibiotics. The thing is, you really need to get tested to know you have one.

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"One of the most important things people need to know is that most STDs have absolutely no symptoms at all," Elizabeth Torrone, PhD, epidemiologist at the division of STD prevention at the CDC, tells BuzzFeed Health.

Plus, symptomless STIs aren’t necessarily harmless. If infections continue without being treated, this can lead to more serious health complications or increase your risk of contracting other STIs or HIV.

"Untreated chlamydia and gonorrhea can cause very poor health outcomes in women, such as pelvic inflammatory disease (PID), ectopic pregnancy, and infertility," Jessica Frasure-Williams, director of programs and partnerships at the National Coalition of STD Directors (NCSD), tells BuzzFeed Health.

Luckily, getting tested is actually really quick and easy. Here's how to find free (or cheap), confidential testing near you:

Step 1: Use an online search engine to find nearby testing sites that offer free or affordable services.

gettested.cdc.gov

GetTested is a free website run by the CDC. Just enter your location to see all the options in your area, plus a list of all the testing services they provide.

"It incorporates over 9,700 databases and aggregates test locations such as state and local health departments, community clinics, Planned Parenthood centers, and advocacy organizations that are either funded directly or indirectly by the CDC and provide these services at no cost," Brian Katzowitz, health communications specialist at the CDC, tells BuzzFeed Health.

"The site is updated every year and CDC staff will call each clinic listed to ensure the listings are accurate — so everything is verified by CDC for quality control," says Katzowitz.

Those search results will show you clinics that offer at least some STI testing services for free. But that doesn't mean that everything will be free for everyone.

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Some of the clinics will offer free testing to everyone regardless of whether or not you have insurance. These free "safety net clinics" are usually geared toward uninsured or low-income individuals, and might include non-profits and charities, mobile testing vans, privately-funded clinics, family planning centers, immigrant health clinics, or LGBT organizations. "In these free clinics, anyone can walk in and you don't have to give your insurance information, so you can get free and confidential services," says Torrone.

Other testing locations might offer services on a sliding scale, which means they charge based on your ability to pay. "It really depends on how the clinic is funded — some community health centers or other quasi-governmental clinics will offer preventive health services like STI testing on a sliding scale so you could be subject to fees," Fred Wyand, director of communications at the American Sexual Health Association (ASHA), tells BuzzFeed Health.

Additionally, some clinics may only offer free testing for certain STIs and charge for any other tests that are considered to be more comprehensive. "All that being said, these centers still want to help you and keep you safe, so you can always talk to staff about payment to figure out your options," Wyand says.

The best way to find out if testing will be free and confidential is to do research online or call the clinic yourself.

Let's say you're on your parents insurance and you don't want them to find out you went for an STI test. Or maybe you have insurance but you can't afford to pay for tests at this time. You should still be able to get free testing at these sites, but you won't know for sure until you ask.

Undocumented immigrants can also seek STI services at these free clinics. "You should not be asked for documentation in clinics run by public health departments or other free STI testing clinics, that's not normal," Dr. Kathleen Page, Chief of STD/HIV/TB clinical services at the Baltimore City Health Department, tells BuzzFeed Health. But if you're worried about documentation, you can always call the clinic ahead of time and ask what kind of identification you need to present in order to get services.

You can also try these sites to find free or sliding-scale clinics in your area:

* STDcheck.org

* TeenSource.org

* FreeSTDcheck.org

* Planned Parenthood

If you already have insurance and just want to see your doctor, you may be able to get some STI tests for free (or with a copay).

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Regular STI screening is recommended for many people, for obvious reasons stated at the beginning of this article; and insurance plans must cover the cost of certain preventive STI screenings (with no copay) in order to be compliant with Affordable Care Act (for now). To find out which screenings are recommended for you, you can check out the recommendations from the US Preventive Services Task Force. Anything that's graded A or B is considered a preventive health service, says Frasure-Williams, so you don’t have to pay any fees or a copay for these if they apply to you.

Your insurance might only cover annual screenings for certain STIs, and any additional tests might require a copay. If you have symptoms, that might technically be an STI "test" rather than a "screening." It should still be covered by insurance, but you may have a copay. All of the USPSTF screenings agree with the CDC guidelines, and some of the most basic recommendations for cisgender men and women include:

* If you’re a woman under 25 and you have sex with men or women, you should get a chlamydia test and gonorrhea test every year.

* If you’re a woman 25 or older AND you have either a new partner or multiple partners (of either gender), you should get a chlamydia test and gonorrhea test every year.

* If you’re a man who has sex with men (MSM), you should be tested for chlamydia, gonorrhea, and syphilis at least once a year.

* All men who have sex with men should get a baseline screening for hepatitis B if they are unvaccinated or if they aren’t sure if they’ve been vaccinated.

* Everyone between the ages of 13 and 64 should get an HIV test at least once in their lives. You may need to be screened more often based on your risk factors.

Step 2: Make an appointment, and confirm whether the services you want are free beforehand.

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Despite everything you read on the internet or the clinic's website, it's always a good idea to call ahead and make sure that a) the clinic offers the services you are looking for and b) they offer them for free.

If you're looking for LGBT-friendly or trans-specific care, it might be worth doing some research beforehand to make sure the clinic you're visiting offers the right services. "Most public health departments and Planned Parenthood centers are LGBT-friendly and have specially-trained staff, but you can always call and check to make sure," says Page. And if they don't, they can still help.

"If that clinic you call doesn't offer the services you need — don't just hang up and give up, but instead ask them to point you to the right resources or suggest another clinic that does have what you need or want," Wyand says.

Keep in mind when making an appointment that some STIs take a little while to show up on a test — so timing matters.

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Every STI has a different incubation period, or the length of time between when you first contracted the infection and when it can be detected by laboratory testing methods. So if you've been exposed to an STI, it could take a matter of days or even weeks for it to show up.

It's important to be aware of incubation periods when you're scheduling your appointment so you can get the most accurate results possible. Click here to see when you should get tested based on the incubation periods for common STIs.

Step 3: Once you're at the clinic, you'll need to chat with the doctor or nurse to find out which STI tests you need.

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The STI tests you need will likely depend on both demographic and behavioral factors, such as your gender, age, whether you have sex with women or men (cisgender or trans) or both, what kind of sex you have, and whether you use protection. "A lot of people think that getting tested means getting a full workup for all of the STDs but that's not always the case depending on who you are and who you have sex with," says Frasure-Williams.

The GetTested site includes a new feature which allows you to find out which test(s) you may need depending on your age, gender, and sexual behavior. This can help you prepare for your visit and give you a better understanding of which tests you might need, Wyand says, but it should not replace your conversation with a healthcare provider.

During your appointment, it's important to be as open and honest as possible about your sexual behaviors.

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Sure, it isn't the easiest conversation to have with a complete stranger, but you really need to be upfront about your sexual history and experiences in order to get the right tests and the best care. And depending on your risk profile, your doctor may recommend routine testing for certain STIs.

"Getting the right STI tests really hinges on our ability to have open, honest discussions with doctors — remember that they won't judge you, they just want to help you stay safe," Wyand says. It may also help you to start these conversations with your partner(s) as well.

"Young people should feel empowered when talking to their provider and feel like they can ask them any questions about sex or getting tested instead of just waiting and hoping their provider brings it up," says Torrone. And if you don't feel comfortable speaking with your doctor, remember you can always speak up and change providers or ask to see someone else.

Good news: Most STI tests are relatively quick and non-invasive.

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Screening for chlamydia and gonorrhea usually requires just a urine sample or swab — you can do the swab on your own or the doctor may do it for you, says Frasure-Williams. If you've had oral sex or anal sex, or you're man who has sex with men, they may also collect swabs from your throat or rectum. Diagnosing HPV also requires a swab.

Diagnosing genital warts will require a physical examination, whereas bacterial vaginosis and trichomoniasis can be diagnosed through either physical examination of vaginal discharge or a swab of the urethra.

Syphilis, HIV, herpes simplex virus (HSV), and hepatitis b all require a blood test, which can either be done by drawing blood from a vein or with a finger-prick device. Syphilis and herpes might also require swabs from any open lesions or sores.

Minors are allowed to get STI services without their parent's consent in all 50 states, but some states require minors to be of a certain age.

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"Minors can consent on their own for testing and treatment for STIs, especially if they explicitly request that the services stay confidential, but it's up to the state to decide how young the minor can be to consent," Frasure-Williams says. According to the Guttmacher Institute, there are 11 states which require a minor to be of a certain age — either 12, 14, or 16 — in order to consent for STI services.

Heads up: If you're on your parents insurance, the STI services might still show up on the statement that comes in the mail.

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Let's say you used your insurance when getting tested, and that insurance comes from your parent's plan. It's possible that your parents will get a letter in the mail detailing the services you received, which is called an explanation of benefits. Every insurance company has different policies when it comes to the explanation of benefits statement. It could just show up as a regular doctor's appointment or a lab test, or it might straight up say "chlamydia test."

"It varies from state to state whether the EOB goes to the primary insurance holder, which would be the parents in this case, or the patient," Wyand says. One solution is to call the customer care number listed on your card and ask what exactly shows up on the EOB and who it goes to. Depending on how that conversation goes, you might just want to go to a free clinic where your insurance information isn't collected if you really don't want your parents to find out.

If you're ever concerned about confidentiality, you can always talk to the clinic staff or your doctor.

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There's a grey area, says Torrone, because there are also state laws that dictate exactly which services can be provided without a parent and whether the doctor has the right to notify parents of positive test results. In 18 states, doctors are allowed but not required to inform parents — so it's important that minors know they can ask for services to remain confidential.

"If you are concerned for your safety if your parents find out about testing, which we sometimes see among LGBT youth, you should talk to your doctor or maybe get a referral to an anonymous testing site," Frasure-Williams says.

Remember: If you're experiencing any strange symptoms or think you have a sign of an STI, go get tested immediately.

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It's not scary or awkward or awful — it's just part of being a responsible, sex-having adult.

And you can always prevent STIs in the future by using condoms, getting vaccinated, and staying informed.

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The truth is that the only way to 100% avoid contracting STis is to abstain from any sexual activities altogether. However, there are several effective ways to prevent STIs when you are sexually active.

According to the CDC, effective strategies for reducing your STI risk include: consistent use of latex condoms during vaginal, anal, and oral sex; vaccines to prevent HPV and Hepatitis B; mutual monogamy; having fewer partners; and talking with partners about STIs and any test results.

"Young people should have these conversations about STDs and getting tested with their friends," says Torrone. "It's a small way to fight the larger stigma and it can help people feel more comfortable and in control of their sexual health."