Anal sex STD testing

[Hp122487]

Hello Doctor,

I recently read that if you have had anal sex you should be tested anally for STDs. I have been tested vaginally for all bacterial STDs and all blood born STDs (including HIV) and have come up negative for everything. I asked my OBGYN today about testing anally for STDs and she looked at me like I was crazy and told me they do not perform that test.

I am not extremely concerned because I only had anal sex once with someone that I was with for an extended period of time, and obviously had unprotected vaginal sex with this person many times in that period. Therefore, my logic is that if he did not give me any STDs vaginally during all those instances of unprotected sex, the likelihood of him giving me something during one instance of unprotected anal sex seems slim (I am assuming that I do not have to worry about blood born disease like HIV or hepatitis because they are not specific to one location, and I have been tested and cleared for those). My doctor seemed to agree with me on this. However, I'd be interested in your opinion as well. Just as a reference, all of this happened at least two or more years ago.

Thank you in advance for your help.

[Edward W Hook, MD]

No, I see no need for you to seek testingfor possible rectal infection.  EWH

[Hp122487]

Just to clarify, you don't think that as of now it is necessary for me to be tested rectally for STDs?

[Hp122487]

Thank you so much for your help, I really appreciate you putting my mind at ease.

[Edward W Hook, MD]

Welcome to our Forum.  Your questions are good ones and your logic is right on target.  In general, any STD can be transmitted through receptive rectal sex.  Thus the list of possible infections includes diseases such as gonorrhea and chlamydia, lesions diseases such as HPV, herpes and syphilis, and blood borne diseases such as hepatitis B and HIV.  In each instance, the tests typically used to diagnose these infections as genital infections (i.e. rectal swabs for gonorrhea and chlamydia, rectal PAP smears for HPV, blood tests for syphilis and HIV) also work for rectal infections.  

In your specific case, the risk from an single exposure over two years ago is low.  HIV and syphilis would show up in a blood tests.  The risk of gonorrhea and chlamydia are low since you were exposed more often genitally and have been tested negative at the genital site.  From a practical perspective, I see no need for you to be tested for rectal infection however, in the future, following  rectal exposures, testing is certainly reasonable.  

I realize this response is a bit convoluted, providing both general information ( first paragraph of my response) and answers specifically for you.  I hope this helps. EWH

[Hp122487]

Just to clarify, I'm mostly concerned with bacterial STDs because I am under the impression that blood born diseases are not only present in certain areas.