STI testing is a crucial component of healthcare for anyone sexually active, regardless of their gender or who they choose to be intimate with. Unfortunately, sexual healthcare like STI testing isn’t easily accessible for everyone — especially for people who don’t live in or around a larger city. 

The advent of online STI testing can change that discrepancy, bringing the ability to stay safe and know their status to everyone, everywhere (as long as they have an internet connection and a device that can connect to the internet). Here’s how it works and why it’s so important. 

What is an STI?

STI is short for a sexually transmitted infection, previously known as a sexually transmitted disease (STD). Sexual health providers and advocates pushed to make the change to help fight the stigma often associated with being diagnosed with a sexually transmitted infection. 

STIs can be passed from person to person through sexual contact — either oral, vaginal or anal. Some STIs can even be passed from mother to child during pregnancy, childbirth or breastfeeding.

STIs include:

• Chancroid.
• Chlamydia*.
• Gonorrhea*.
• Hepatitis A.
• Hepatitis B*.
• Hepatitis C.
• Human immunodeficiency virus (HIV)*.
• Human papillomavirus (HPV)*.
• Herpes simplex virus (HSV)*.
• Syphilis*.
• Trichomoniasis*.

Of the STIs mentioned above, the starred options are diagnosed the most frequently. They are also broken down into two categories — curable and incurable. Chlamydia, gonorrhea, syphilis and trichomoniasis are able to be treated and cured, while hepatitis B, HIV, HPV and HSV are manageable but can’t be cured entirely. 

However, modern treatment options can often keep these viruses and their impact on the immune system enough that many people are no longer symptomatic. The medical progress made with HIV treatment alone in the past decade has been a lifesaver.

STIs can be asymptomatic or involve symptoms like penile or vaginal discharge, growths in the genital area or around the mouth, itching or a rash. The only way to be conclusively diagnosed is through lab testing, however, as many of these symptoms are also a sign of other health conditions.

How common are STIs?

STIs are far more common than people know, mainly because talking about them is often seen as socially inappropriate. However, talking about them also helps reduce the stigma around getting an STI diagnosis — something that the World Health Organization (WHO) estimates happens to over one million people globally every day. 

In the US, tracking STIs is the job of the Centers for Disease Control and Prevention (CDC). For example, in 2021, they reported more than 2.5 million cases of three specific STIs — chlamydia, gonorrhea and syphilis. In many cases, these STIs are asymptomatic, and people aren’t aware that they have contracted them until they have regular lab testing.

How does online STI testing work?

Online STI testing will differ depending on the telehealth company, but the basic structure is the same. Instead of going to an in-person clinic and being physically swabbed by a healthcare provider, telehealth providers will talk to patients about their symptoms and risk factors and order less invasive testing based on that discussion. It is also covered by the same HIPAA rules that pertain to in-office testing. 

Often, this testing is a combination of bloodwork and a urine sample depending on which STIs a patient is most at risk for. Some companies will even mail at-home STI test kits directly to a patient’s house, giving them a more discreet way to test. 

Home test kits may come with a CLIA-waived swab, a cup for urine sample collection, and/or a lancet for a blood sample (via finger prick).

Online STI testing services, whether collected at home or in a testing center, also offer reasonably fast results. But, even more important than same-day test results is the peace of mind that knowing their status gives patients. 

Does online STI testing include treatment?

If a patient does test positive for an STI, a telehealth doctor, like ours at HealthTap, will schedule an appointment to discuss the test results and treatment plan. Each STI requires a slightly different treatment approach. 

At HealthTap, sexual health providers can treat and manage the following STIs:

• Chlamydia.
• Genital warts.
• Gonorrhea.
• Herpes simplex virus (HSV).
• Trichomoniasis.

Other positive STI diagnoses will require a referral for in-person management and follow-up.

All positive results for chlamydia, gonorrhea, HIV, and syphilis are legally required to be reported to the public health department in the state where the patient lives. Reporting is only meant to assist local health centers in developing appropriate resources and allocating money to the community more effectively.

Prevention is key

Prevention of STIs is crucial to prevent long-lasting health consequences. Prevention techniques will vary based on the gender of sexual partners a patient is intimate with. 

For example, people with male bodies who are intimate with people with male or female bodies should wear condoms. Dental dams are appropriate for anyone engaging in oral sex with someone with a female body. 

Unprotected sex is safest for people in a monogamous relationship, provided both partners have been tested, and everyone should get tested before having sex with a new partner (even protected sex). However, one of the most effective prevention techniques is sitting down and having an open, honest conversation with a potential partner. 

While those at a higher risk of HIV exposure should strongly consider pre-exposure and post-exposure prophylaxis (more commonly known as PrEP and PEP), telehealth providers cannot prescribe these medications.  

Does health insurance cover online STI testing?

Coverage for telehealth services like online STI testing will vary depending on an individual’s health insurance plan. Some health insurance plans will fully cover these services, while others don’t offer any coverage at all. 

The good news is that, even completely out of pocket, the cost of a HealthTap appointment is often similar to or less than the copay for an in-person appointment.