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The STIs You Cannot Feel: Why a Walk-In Sexual Health Clinic Matters When You Feel Fine

You feel healthy. Nothing hurts. Nothing looks wrong. But feeling fine is not the same as being fine. Most sexually transmitted infections produce no symptoms at all, and by the time they do, the damage is already done.

By Aimee Zuccarini · · Reviewed by Dr. Samantha Naidoo, MB ChB, FCP (SA)
✓ No doctor's referral🕑 15-minute visit🔒 Confidential results

Every other page on this website tells you what we test for and how to get tested. This one explains why you need to test even when nothing feels wrong. It is the most important page you will read here, because the infections that cause the most damage are the ones you never feel.

The Silent Six: STIs That Produce No Symptoms

Chlamydia

Asymptomatic in up to 70% of cases

Chlamydia is the most commonly reported bacterial STI in the world. The reason it spreads so effectively is that the majority of people who carry it feel nothing at all. There is no pain, no discharge, no visible sign. A person can carry chlamydia for months or years without any indication that something is wrong.

How long it stays silentMonths to years. Many people only discover they have it when a partner tests positive, or when complications develop.
What it does if untreatedPelvic inflammatory disease (PID), chronic pelvic pain, ectopic pregnancy, infertility. In men, epididymitis and reduced fertility.

HPV (Human Papillomavirus)

Almost never causes symptoms

HPV is the most common STI globally. Most sexually active people will contract at least one strain in their lifetime. The virus produces no pain, no sores and no discharge. It can only be found through screening. It sits in the cells and replicates quietly. The body clears most strains on its own within two years, but high-risk strains can persist and cause cell changes that lead to cancer years or decades later.

How long it stays silentYears to decades. Cervical cell changes caused by HPV are typically detected only through screening.
What it does if untreatedCervical cancer, throat cancer, anal cancer. South Africa has one of the highest cervical cancer rates in the world. Screen for HPV.

Gonorrhoea

Asymptomatic in up to 50% of vaginal infections, 10% of penile infections

Gonorrhoea can produce symptoms such as discharge and pain during urination, but in a significant proportion of cases, particularly vaginal infections, it produces none. Throat and rectal gonorrhoea are almost always asymptomatic.

How long it stays silentWeeks to months. Throat and rectal infections can persist indefinitely without symptoms.
What it does if untreatedPID, infertility, disseminated gonococcal infection (joint pain, skin lesions, endocarditis). Growing resistance to treatment globally.

Herpes (HSV-1 and HSV-2)

Up to 80% of carriers do not know they are infected

Herpes is carried by a large proportion of the global population. Most carriers have never had a visible outbreak. The virus lives in nerve cells and can reactivate at any time, but many people shed the virus without any sores at all. This is called asymptomatic shedding, and it is the primary way herpes spreads.

How long it stays silentIndefinitely. Many people carry herpes for their entire lives without a single visible outbreak.
What it does if untreatedRecurrent outbreaks, neonatal herpes (serious risk during pregnancy), increased susceptibility to HIV.

Syphilis

Primary sore is painless and often hidden

Syphilis begins with a painless sore called a chancre, usually at the site of infection. Because the sore does not hurt, it is often missed entirely, especially if it appears internally. The sore heals on its own within weeks, and the person assumes they are fine. The infection then enters a latent stage that can last years with no symptoms at all.

How long it stays silentThe latent stage can last 10 to 30 years with zero symptoms.
What it does if untreatedTertiary syphilis: damage to the heart, brain, nerves and bones. Neurosyphilis (neurological damage). Congenital syphilis in pregnancy.

HIV

Can be asymptomatic for 8 to 10 years

After an initial flu-like illness (which many people do not notice or dismiss as a cold), HIV enters a long clinical latency period. During this time the person feels completely healthy while the virus progressively destroys their immune system. Without testing, the infection is typically only discovered when the immune system is severely compromised.

How long it stays silent8 to 10 years on average without treatment. Some people remain asymptomatic for longer.
What it does if untreatedProgressive immune destruction leading to AIDS. Opportunistic infections, cancers and death. Early detection and treatment leads to a near-normal life expectancy.
The pattern
Every one of these infections can be present for months or years without a single symptom. Every one of them causes serious harm if left untreated. Every one of them is detectable through a simple test at a walk-in sexual health clinic.

When to Test: Window Periods

Testing too soon after exposure can produce a false negative because the infection has not had time to become detectable. Each STI has a window period, which is the minimum time after exposure before a test can accurately detect the infection.

Chlamydia and Gonorrhoea

PCR detectable from 2 weeks after exposure.

HIV

Antibody test (ELISA) reliable from 4 to 12 weeks. 4th-gen Ag/Ab tests can detect from 2 weeks.

Syphilis

Blood test reliable from 3 to 6 weeks after exposure.

Herpes

Antibody test reliable from 2 to 12 weeks. Swab testing during an active outbreak is accurate immediately.

HPV

PCR detectable at any time after infection. No window period for molecular testing.

Mycoplasma and Ureaplasma

PCR detectable from 2 weeks after exposure.

If you test negative within the window period, retest. A negative result before the window period closes does not rule out infection. If you had a specific exposure you are concerned about, test once now and again after the relevant window period has passed.

Who Should Test Routinely

The short answer: everyone who is sexually active. The longer answer depends on your circumstances.

Annually if you are in a monogamous relationship and both partners have been tested. After every new partner regardless of whether protection was used. Every 3 to 6 months if you have multiple partners. Immediately if a partner tells you they have tested positive, if you had unprotected sex with someone whose status you do not know, or if you notice any unusual symptoms.

None of this requires a doctor's referral. Students get 10% off. A walk-in sexual health clinic exists precisely for this: routine, confidential screening that takes 15 minutes.

What a Walk-In Sexual Health Clinic Tests For

HIV Screening

ELISA blood test.

R168
R42/mo × 4 with Payflex
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Sexual Health Express

5-in-1 blood screen: HIV, syphilis, hepatitis B, chlamydia, herpes.

R1,076
R269/mo × 4
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Medium STI Package

9-target PCR: chlamydia, gonorrhoea, herpes, mycoplasma, ureaplasma, trichomoniasis. Home kit available.

R1,508
R377/mo × 4
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Extra Large Package

35-target comprehensive PCR. Full STI and vaginal microbiome screen.

R3,305
R827/mo × 4
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All prices include VAT. 10% student discount. 10% pensioner discount. Payflex interest-free instalments on all packages. Home test kits available for PCR swab tests.

Frequently Asked Questions

Can you have an STI without symptoms?
Yes. Most STIs are asymptomatic for at least part of their course. Chlamydia shows no symptoms in 70% of cases. Gonorrhoea is silent in up to 50% of vaginal infections. HPV almost never causes symptoms. Herpes can be dormant for years. HIV may cause no symptoms for a decade. The only way to know your status is to test at a walk-in sexual health clinic.
How long can you have an STI without knowing?
It depends on the infection. Chlamydia: months to years. HPV: years to decades. Syphilis: the latent stage can last 10 to 30 years. HIV: 8 to 10 years without treatment. Herpes: indefinitely. Many people only discover an infection when a partner tests positive, when they develop complications, or through routine screening.
What damage can untreated asymptomatic STIs cause?
Chlamydia and gonorrhoea: pelvic inflammatory disease, ectopic pregnancy, infertility. HPV: cervical, throat and anal cancers. Syphilis: heart, brain and nerve damage. HIV: progressive immune destruction. Early detection through a walk-in sexual health clinic prevents all of these outcomes.
Which STIs should I test for if I have no symptoms?
At minimum: HIV, chlamydia and gonorrhoea. Ideally add syphilis, hepatitis B and herpes. If you have a cervix, add HPV screening. The Sexual Health Express (R1,076) covers five infections via blood. The Medium PCR Package (R1,508) adds swab-based detection for nine targets.
How often should I get tested?
Annually if sexually active with one partner. After every new partner. Every 3 to 6 months if you have multiple partners. Immediately if a partner discloses a positive result. No doctor's referral needed.
What is the window period for STI testing?
The window period is the time after exposure before a test can detect the infection. Chlamydia/gonorrhoea PCR: 2 weeks. HIV antibody (ELISA): 4 to 12 weeks. Syphilis: 3 to 6 weeks. Herpes: 2 to 12 weeks. HPV: no window period for molecular testing. If you test negative within the window period, retest afterwards.
Do I need a doctor's referral for STI testing?
No. Epicentre is a walk-in sexual health clinic. No referral, no appointment, no GP visit needed. Walk in Mon – Fri, 08:30 – 16:00 at Durban (Hillcrest), Cape Town (Observatory), or Johannesburg (Parktown North). Home test kits also available.
Where is the nearest walk-in sexual health clinic?
Durban: 2 Knelsby Avenue, Hillcrest (031 880 2150). Cape Town: 24 Lower Main Road, Observatory (021 201 1658). Johannesburg: 02 7th Avenue, Parktown North (082 065 2172). Mon – Fri, 08:30 – 16:00. Home test kits delivered nationwide.

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Medically reviewed by Dr. Samantha Naidoo
MB ChB, FCP (SA) · Medical Director, Epicentre Laboratories

Epicentre Walk-In Labs does not provide medical diagnoses. For medical diagnoses and advice, please consult your healthcare practitioner. Practice #1117394.

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