Why isn't hpv included in a routine std test or pap? so many people have it and think they are std free because they are ignorant about it.

Having HPV is normal: Testing IS done with pap smears. However, getting genital HPV is normal, expected, and unavoidable except by those who choose a lifetime of celibacy. Infections cannot be treated, and knowing someone is infected has no benefit for the patient or his/her sex partners. Precautions are necessary to prevent bad outcomes, including immunization and pap smears (or HPV testing) after age 25 or 30.

It usually is: It is the recommendation that it is done routinely but it is an expensive test with the technology not available everywhere. Accommodations must be made for docs not able to comply. You must remember, there are still people doing smears on a slide. For those docs that can get it done but don't, we must take the time to update our education if we are going to provide the service.