Essential STD Testing Guidance for Young Adults in Relationships

What tests should be conducted if there are concerns about an infection in the following situations?

Hello Doctor: I would like to explain our situations.
Female - 22 years old: Three years ago, I was cheated on by my first boyfriend.
After a year, I got together with a girl, and we have had sexual relations.
The male partner used a condom, and the female partner used a finger cot, but we did engage in mutual oral sex and kissing.
It is confirmed that neither of them are virgins, and their previous partners were not either.
We also did a rapid test at school, which involved pricking a finger to draw blood and applying it to a test paper.
They said they would call me if the result was positive a week later, but I did not receive a call (this was after I had sexual relations with the female).
Male - 24 years old: He mentioned that he has been in relationships with six girls, all of whom he had sexual relations with, and none of them are virgins.
His last sexual encounter was four months ago.
After that, we had intercourse on June 16, using a condom, with oral and vaginal penetration.
I performed oral sex on him, and he likes to eat what I have eaten or wants me to eat what he has eaten.
However, after intercourse, when he pulled out, the condom had slipped off halfway, and he ejaculated.
I have a few questions:
1.
Why did the condom slip off halfway (after ejaculation)? What should I be aware of?
2.
I tend to be more cautious and easily worried about this aspect.
After discussing my concerns about potential STDs with him, he mentioned that he has not undergone any health checks but does not rule out getting tested.
What tests would you recommend in this situation?
2-1: Recommendations for the female (me)
2-2: Recommendations for the male
Because I found that the tests online are quite expensive, and each item is charged separately, it seems that general health check-ups do not include these aspects like HIV, syphilis, etc.
Could you please help clarify this or point out anything I should be aware of that I have not mentioned or noticed? Thank you, Doctor.

Xinti, 20~29 year old female. Ask Date: 2018/06/18

Dr. Chen Jiansheng reply Urology

1.
When withdrawing the condom, it is important to hold the base to prevent any semen from spilling out or the condom from slipping off.

2.
Common sexually transmitted infections (STIs) include HIV, syphilis, herpes, gonorrhea, and chlamydia.
These can be detected through blood tests or urine tests.
Men often exhibit more noticeable symptoms, such as painful urination and discharge, while women may have less obvious symptoms.

3.
You can visit a medical clinic certified by friendly STI physicians.
[http://www.tua.org.tw/tua/index.php/tw/subspecialty](http://www.tua.org.tw/tua/index.php/tw/subspecialty)

Reply Date: 2018/06/18

More Info

When it comes to sexually transmitted diseases (STDs) and testing, especially for young adults in relationships, it's crucial to prioritize health and communication. Based on the details you've provided, here are some essential guidelines and recommendations.

Understanding Condom Use and Risks
1. Condom Slippage: The fact that the condom slipped off partially during intercourse can happen for several reasons, including improper sizing, lack of lubrication, or not ensuring the condom is securely in place before penetration. It's important to check the condom before and after use to ensure it hasn't broken or slipped off. If a condom is not used properly, it can lead to exposure to STDs and unintended pregnancies.

2. Post-Intercourse Precautions: After any sexual encounter, especially if there was a concern about condom failure, it's advisable to consider emergency contraception if pregnancy is a concern and to monitor for any unusual symptoms that may arise in the following weeks.

Recommended STD Testing
Given your situation, both you and your partner should consider getting tested for STDs. Here’s a breakdown of what to consider:
#
For You (the Female Partner):
1. Comprehensive STD Panel: This should include tests for:
- Chlamydia and Gonorrhea: These are common bacterial STDs that can be asymptomatic.

- HIV: It's essential to know your status, especially since you’ve had multiple partners.

- Syphilis: A blood test can determine if you have this infection.

- Hepatitis B and C: These viruses can be transmitted sexually and have long-term health implications.

- Herpes Simplex Virus (HSV): Testing for HSV-1 and HSV-2 can be done, especially if you have symptoms.

2. Pap Smear: If you haven’t had one recently, a Pap smear is important for cervical health and can also test for HPV, which is linked to cervical cancer.

#
For Him (the Male Partner):
1. Similar STD Panel: He should also undergo the same tests for Chlamydia, Gonorrhea, HIV, Syphilis, Hepatitis B and C, and Herpes.

2. Communication: Encourage him to be open about his sexual history and any symptoms he may have experienced. This can help guide the testing process.

Cost Considerations
- Community Health Clinics: Many areas have community health clinics that offer free or low-cost STD testing. It’s worth researching local resources.

- Insurance: Check if your health insurance covers STD testing. Many plans do cover these tests as part of preventive care.

- At-Home Testing Kits: There are also at-home testing kits available for some STDs, which can be a convenient option.

Importance of Open Communication
Discussing sexual health openly with your partner is vital. It can be uncomfortable, but it’s necessary for both of your health and well-being. Make sure to express your concerns and encourage him to be proactive about his health.

Conclusion
In summary, both you and your partner should get tested for STDs, especially after any incidents of condom failure. Use this opportunity to foster open communication about sexual health and safety. Remember, being proactive about your sexual health is an important part of any relationship. If you have any further questions or concerns, don’t hesitate to reach out to a healthcare professional for personalized advice.

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