Take Charge of Your Sexual Health

What you need to know about preventive services

M
Home > What Are Preventive Sexual Health Services? > Preventive Sexual Health Services for People with a Vagina/Vulva > Screenings

Screenings

Sexually Transmitted Infections (STIs)

All sexually active individuals with a vagina/vulva who are aged 24 and younger should be screened annually for chlamydia and gonorrhea. Those aged 25 and older who have risk factors for STIs, such as having unprotected sex (sex without a condom), a new partner, or multiple partners, should also be screened for both chlamydia and gonorrhea.

Talk with your provider about being screened for syphilis. You may need to be screened if you have multiple partners, have HIV, have exchanged sex for money or drugs, or have been in prison.

All pregnant people should be screened for syphilis, HIV, hepatitis B, and hepatitis C during their first prenatal visit or within the first trimester. Pregnant people aged 24 and younger, as well as older pregnant people (age 25 and over) with risk factors for STIs, should also be screened for chlamydia and gonorrhea. Those who are at continued risk for STIs should be retested for chlamydia, gonorrhea, syphilis, HIV, and hepatitis B in their third trimester. For those who receive positive chlamydia and/or gonorrhea results, it is recommended to get retested 3 months after treatment.

Additionally, people with a vagina/vulva in high-risk settings and with other risk factors for STIs should consider being tested for trichomoniasis. This includes those with multiple sex partners, those exchanging sex for payment, those using illicit drugs, and those with a history of STIs or incarceration. Those receiving care in high-prevalence settings (e.g., STI clinics and correctional facilities) may also consider testing.

HIV Testing

Everyone between the ages of 13 and 64 should be tested for HIV at least once as part of your routine health care, even if you have never had sex or you think your partner only has sex with you.

You should be tested at least once a year if you have unprotected sex, have had an STI or have a partner who has an STI, have multiple partners, share drug injection equipment (including needles or syringes), or have  partners who engage in any of these behaviors.

Cervical Cancer Screening

Starting at age 21, even if you haven’t had vaginal sex, your health care provider should screen for cervical cancer and continue doing so until age 65. Screening means checking for a disease or for changes that might lead to disease. There are two types of testing that can screen for cervical cancer: the Pap test and the HPV test.

The Pap test looks at changes in cervical cells – caused by HPV – that might turn into cervical cancer, if not treated. An HPV test checks cells for infection with high-risk HPV types that can cause cervical cancer. The type and frequency of screening will depend on your age and health history.

People with a vagina/vulva should have their first Pap test at age 21. If the results are normal, they should have the test every three years until age 29. If the results are not normal, your health care provider might recommend more frequent testing.

Those ages 30-65 can usually choose from one of three screening options: 1) HPV test every five years, 2) HPV/Pap test every five years, or 3) Pap test every 3 years. You may need to be screened more often if you’ve had an abnormal result. If so, talk with your provider.

People with a vagina/vulva who are HIV-positive should be screened for cervical cancer within 1 year of sexual activity or initial HIV diagnosis. Testing should be repeated 6 months later.

Remember, a Pap test does not test for STIs, nor does it test for other cancers of the reproductive system.

Even though you may not need annual screening, you should still see your provider regularly for checkups. To learn more, visit: https://www.cdc.gov/cancer/cervical/basic_info/screening.htm.

Hepatitis B Screening

You should be screened for hepatitis B if you are pregnant, have a partner who has hepatitis B, have multiple partners, have had an STI, share drug injection equipment (including needles or syringes), have HIV, or live with a person who is infected with the hepatitis B virus.

You should also be screened if you were born in a country where hepatitis B infection is common (Asia, Africa, the Pacific Islands, parts of South America) or were born in the United States to parents from one of those countries.

Hepatitis B is a virus that attacks the liver. It is spread through infected body fluids, including blood and semen. Infection can either be acute (short-term) or chronic (long-term). People with hepatitis B may not look or feel sick but can still infect others. Chronic hepatitis B infection can often be treated, but not cured.
To learn more, visit cdc.gov/hepatitis/hbv/index.htm.

Hepatitis C Screening

People with a vagina/vulva ages 18 to 79 should be screened once for hepatitis C, and most people who are pregnant should be screened during each pregnancy.

Many “baby boomers” have hepatitis C and don’t know it. They may have engaged in risky behaviors or received a blood transfusion or organ transplant before national screening for the virus was in place. Most people become infected with hepatitis C by sharing drug injection equipment. If you inject illegal drugs, you should be screened periodically for hepatitis C. You should also be screened if you’ve been in prison, have HIV, or have ever injected illegal drugs.

The risk of getting hepatitis C from having unprotected sex is low, but it is possible. You are at higher risk if you have HIV or another STI, have multiple partners, or engage in rough sex.

Hepatitis C is a virus that attacks the liver. It can cause severe illness and permanent liver damage. However, it can often be cured, especially if the infection is detected early.

To learn more, visit cdc.gov/hepatitis/hcv/index.htm.

Genital Herpes

Genital herpes is a very common sexually transmitted infection (STI). In fact, more than one in six people (ages 14 to 49) currently have it.

You can get genital herpes during anal, oral, or vaginal sex, or by skin-to-skin contact in the genital area with an infected partner. If you have herpes in your mouth, you can spread it to your partners genitals during oral sex.

Genital herpes is caused by two different viruses – HSV-1 and HSV-2. Most people with genital herpes have no symptoms or very mild symptoms. And, many don’t know they are infected. If you do have symptoms, herpes often appears as blisters or sores on or around your genitals, rectum, or mouth. Typically, as time goes on, people have fewer outbreaks, which are shorter and milder.

Routine screening for genital herpes is not recommended. However, testing is recommended for people:

A health care provider may diagnose herpes by: 1) simply looking at your symptoms 2) taking a sample from a sore and testing it 3) doing a blood test. Talk with your health care provider about what they recommend for you.

While there is no cure for herpes, effective medications are available that can prevent and shorten outbreaks, and reduce the risk of giving it to your partner(s). By avoiding sex during outbreaks and using condoms or dental dams every time you have sex, you can also reduce risk.

To learn more, visit https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm

Intimate Partner Violence 

If your partner is sexually, verbally, or physically abusing you, or forcing you to do things against your will (such as getting pregnant, not using birth control, or engaging in unsafe sex), speak up and let your provider know. They can refer you to a program or mental health professional who can help you. Love is Respect (https://www.loveisrespect.org/) and the National Domestic Violence Hotline (https://www.thehotline.org/) also have resources, phone lines, and online chat support to help.

WOMEN WHO HAVE SEX WITH WOMEN

If you are a woman who has sex with women, you still need many of these preventive services. You can get chlamydia, gonorrhea, HPV, and other sexually transmitted infections from your female partners. You also need to be tested for HIV, especially if you or your partners had sex with men in the past or still do. The HPV vaccine will help protect you from getting cervical cancer, which is caused by the human papillomavirus.