The STI testing questions our nurses get asked every day

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

Yes. Just say “I'd like to test anonymously” when you check in. Give us any name you like and an email address only you can see. Pay cash or card. We don't submit anything to your medical aid, nobody gets an SMS, and there's no paper trail. Your results go to that email and nowhere else.

One tip: remember the name you used. It's the only way we can match your results to you.

Sister LindiweRegistered Nurse, Observatory, Cape Town

You never have to say those words. Ask for a package by its name, “the Medium” or “the Large”, or just show us the page on your phone. All the questions happen in a private room with the door closed. Nobody in the waiting area hears anything.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

Yes! Lots of couples test together before they stop using condoms. You can be in the room together or separately, your choice. Just tell us when you arrive.

And it's a good idea for another reason. If one of you tests positive and the other never tests, the infection just goes back and forth. Whatever your result, your partner should be tested too.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

This is the question I get most. Change how you frame it. Instead of making it about trust, make it about the two of you being open and relaxed together. Something like: “I want to take this to the next level. Could we get tested together, so we can both relax and not stress about anything?”

If they react badly, honestly, that's a red flag for me. Someone who won't help you stay healthy isn't someone you want to be having sex with.

Sister LindiweRegistered Nurse, Observatory, Cape Town

You can, but it won't tell you much yet. An infection needs time to multiply before any test can find it. For the PCR panels, wait 1 to 2 weeks. For HIV, the 4th-generation lab test picks it up from about 2 to 4 weeks, and a confirmed negative is at 12 weeks. Syphilis is 3 to 6 weeks.

So the sensible plan is a PCR panel in 1 to 2 weeks, then the blood tests at 6 weeks. Come and see us and we'll work out the timing for your situation.

One exception, and it matters: if you think you've been exposed to HIV, don't wait for a test at all. PEP, the 28-day course that stops HIV taking hold, has to start within 72 hours and works best in the first 24. Go straight to a clinic or emergency room. We don't offer PEP, but they do.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

That rule is out of date. The old antibody tests needed up to 3 months. The 4th-generation lab test we use looks for the virus's p24 antigen as well as antibodies, so it detects most infections from 2 to 4 weeks after exposure.

The part most people don't know is that someone who was infected recently is at their most infectious, because the virus is multiplying fast, even while they're still testing negative. That's why a recent negative result from a new partner isn't the whole story, and why the 12-week confirmation still matters.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Yes, 100%. I always recommend screening even if you feel perfect, because silent infections like chlamydia or Mycoplasma genitalium often show no symptoms while they're active.

Once a year is a good routine check. Add a test if you've had a close call, or before you stop using condoms with someone new. After a possible exposure, wait 1 to 2 weeks before a PCR test, or the lab might miss it.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

It's not about trust. Some infections sit quietly for years before anyone notices. HPV, herpes, Mycoplasma genitalium and even syphilis can be there from a previous relationship without either of you ever feeling ill.

What I see more often in long relationships is the ping-pong pattern: one partner has recurring BV or thrush, gets tested, and the other partner never does. The two of you just pass it back and forth. A test for both of you, once, breaks the loop. Think of it like a yearly blood pressure check, not an accusation.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Not necessarily. In our lab, roughly 1 in 4 people who come in for a routine screen with no symptoms at all test positive for at least one infection. Chlamydia, Mycoplasma genitalium, ureaplasma, HPV, herpes and early syphilis are all routinely silent.

Feeling fine tells you that you feel fine. A PCR test tells you what's there.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

Chlamydia and Mycoplasma genitalium. They usually cause no symptoms, so people carry them and pass them on without knowing.

Syphilis surprises people too. They think of it as old-fashioned, but I've seen a big rise in Joburg. It often starts with a single painless sore that goes away on its own, so people think they're fine while the infection moves deeper into the body.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Yes, and it's really common. Gonorrhoea can live in the throat or rectum with no symptoms. Syphilis is known for a small, painless sore that disappears while the infection stays active inside. Neither has to cause visible sores, discharge or pain.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Yes, and they're the ones that worry me most. Most basic screens look for a short list, usually HIV, syphilis, chlamydia and gonorrhoea. Mycoplasma genitalium and ureaplasma fly under the radar, and they're common in South Africa.

They're also awkward bacteria. They have no cell wall, which is what many standard antibiotics attack, so a guessed treatment often doesn't touch them. Untreated, M. genitalium can cause pelvic inflammation, chronic prostatitis and infertility while you feel completely well. That's why our Medium panel and up test for both by name.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

No, thank goodness. The bacteria and viruses we test for are fragile. HIV, syphilis, chlamydia and HPV don't survive long on a cold, hard surface. They need warm, direct body-to-body or skin-to-skin contact to move from one person to another.

There's a theoretical chance with trichomoniasis if you sat on fresh fluid with an open wound. In all my years in the lab I've never seen a real case of it. You're far more likely to pick up a cold from the door handle.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

It's the opposite. For sexual health, PCR is the most reliable method we have. Older tests need bacteria to grow in a lab dish. PCR finds the DNA of the infection itself, so it can pick up even a very small amount.

A PCR result can only mislead you in two situations: if you test too soon after an exposure, before the infection has multiplied, or too soon after finishing treatment, while leftover DNA from dead bacteria is still there.

Sister LindiweRegistered Nurse, Observatory, Cape Town

I'd gently steer you away from it. Two problems. First, if the bacteria are resistant, which we see a lot of in South Africa with Mycoplasma, a standard course won't clear it and you'll think you're sorted when you're not. Second, every unnecessary course knocks out the good bacteria in your gut and vagina, which is often what starts a cycle of BV or thrush.

Test first. Then, if something is there, your doctor can prescribe the specific antibiotic that will clear it the first time.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Sometimes it is, but it's a gamble. Standard treatment only starts when you have symptoms, so silent infections never get treated. And Mycoplasma genitalium in South Africa is often resistant to the medicines in the standard treatment packs, so the infection can carry on after you've finished them.

I'm not suggesting a PCR test after every encounter. A yearly check finds these infections before they cause problems like infertility, and the report shows your doctor exactly what's there, so the first treatment is the right one.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

Yes to both. Men can, and should, be tested for HPV, not only women having a Pap smear. Our PCR panels from the Medium up include HPV, for any anatomy.

Men can also have the HPV vaccine. It won't clear a type you already have, but it protects you against the types you haven't met yet, including the ones behind genital warts and cancers of the throat, penis and anus. It protects your partners too. Ask a doctor or pharmacist which ages it's offered for and what it costs.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

Not all HPV is the same. There are over 200 types, and the ones that cause warts are low-risk types that almost never lead to cancer. So it's more of a nuisance than a danger, and nothing to panic about. If you'd like them removed, that's a conversation with your doctor.

Warts on the genitals can pass to a partner through skin-to-skin contact. A condom helps if it covers the area, but not if the warts are on the scrotum, pubic area, inner thighs or around the anus. The HPV vaccine prevents most of the wart-causing types, so it's worth a conversation with future partners.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

It's completely normal to feel nervous. HPV is so common that most sexually active adults will have it at some point. For most people, the immune system clears it or keeps it under control within 1 to 2 years, and once a lesion has been treated and gone, the chance of passing it on drops a lot.

Rather than another test before you start dating, I'd suggest the HPV vaccine to protect you from other types, and barriers like dental dams for extra peace of mind. Please don't live in fear. Your body is probably already doing the work.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

A Pap smear looks for changes in the cervix that could lead to cancer, and almost all cervical cancer is caused by high-risk HPV. That's why South Africa's 2024 cervical screening guideline from SASOG recommends an HPV test as the first screening test, because it picks up risk years before cancer could develop.

If a high-risk type is found, you then need a Pap smear and regular follow-up with your doctor or gynae. Our Comprehensive HPV test names each type, so you know whether it's one of the high-risk ones.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

I hear this so often, and it's frustrating when you know something is off. Looking at a swab under a microscope is the classic way to spot thrush or BV, but most modern labs, ours included, use PCR now.

PCR is more precise. A microscope can miss a low-level infection, while PCR picks up the DNA itself, and it can tell ordinary thrush apart from stubborn types that need different treatment. You don't need a doctor's referral: walk in, tell us what's going on, and we'll do a targeted swab.

Sister LindiweRegistered Nurse, Observatory, Cape Town

You're definitely not alone. I asked the head of our sexual health laboratory, and his view is that BV bacteria with no symptoms usually aren't something to worry about. It's very common, especially in South Africa. Some BV bacteria are normal in the vagina, and they only become a problem when they overgrow.

That means treatment may not be needed if it isn't bothering you. Talk it through with your own doctor, who can see your results and history, before you skip or stop any treatment.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Fermented foods like kombucha and sauerkraut are great for your gut, and that can help your vaginal balance a little, but it's slow and indirect. If you have recurring BV or thrush, ask your doctor or pharmacist about vaginal probiotics instead.

Timing matters too. A healthy vagina is slightly acidic. Around your period it becomes less acidic for a few days, and that's when recurring infections often come back.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

It's a common myth that women who have sex with women are at no risk. HPV and herpes pass easily through skin-to-skin contact, rubbing and oral sex. BV is very common between female partners because vaginal fluids and pH are shared so easily. Trichomoniasis and chlamydia can travel on shared toys and hands.

Many of these have no symptoms, so regular screening matters whatever your orientation. You deserve to know your status.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

Looking for bumps and unusual smells is a fair start. The one most people miss: don't brush or floss right before. Tiny tears in your gums are an open door for infection.

Barriers help: flavoured condoms, or a dental dam, which is hard to find in South Africa but easy to make by cutting a condom into a square. And if you've had oral sex, ask us for the throat swab. A genital swab or urine sample won't find an infection that's sitting in your throat. We add the throat swab to any sexual health panel at no extra charge.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

For HIV, oral sex is lower risk than penetrative sex. But it's a very common route for gonorrhoea, syphilis and HPV to travel between genitals and the throat, in either direction.

Penetrative sex with a condom protects you very well against HIV and the infections carried in fluids. Skin-to-skin infections like HPV and herpes can still pass, because a condom doesn't cover all the skin in the genital area.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Yes. Tell the nurse you'd like those sites tested as well when you do your sexual health PCR panel. It costs nothing extra and it covers the same organisms at those sites. If you only test urine, an infection in the throat or rectum will be missed.

Sister LuciaRegistered Nurse, Parktown North, Johannesburg

That fear keeps a lot of people from testing, and it's mostly not true any more. Chlamydia, gonorrhoea and syphilis are curable with the right course of antibiotics from a doctor.

Even with HIV, modern treatment can bring the virus to “undetectable”, which means it can't be passed on and won't stop you living a normal life. With HPV and herpes, the symptoms are very treatable and the body often clears HPV on its own. Some HPV types can lead to cancer, which is why testing for it matters. Most of the time an STI is a speed bump, not a label.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Not at the moment, so for now you'd go to a public clinic or an NGO site. PrEP is a regular medicine that protects you from getting HIV. In South Africa it comes as a daily pill, which is free at public clinics, a vaginal ring you change monthly, and a newer injection twice a year that's being rolled out.

PEP is different: it's an emergency course after a possible exposure, and it has to start within 72 hours. Go straight to a clinic or emergency room for that.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Yes, in the same visit. The PCR panels look for infection DNA in a swab and a urine sample rather than in blood, so it's not literally the same draw, but you can do both while you're here. Lots of people pair their iron or vitamin checks with a sexual health panel.

Tip for the urine sample: try not to go for about an hour before you arrive. It gives us a much better sample.

Sister LindiweRegistered Nurse, Observatory, Cape Town

Order your package online and we courier it to you in a plain, unbranded box. The kit has illustrated instructions for a quick swab and urine sample, with no needles.

When you're done, WhatsApp us to book the courier. Pickup is free within 10km of a branch, and R300 anywhere else in South Africa. Your confidential report comes by email, usually in 5 to 7 working days.

Sister LindiweRegistered Nurse, Observatory, Cape Town

The Large panels, for penile and prostate care or for cervical and vaginal care, are R1,925 and cover 17 targets each, including chlamydia, gonorrhoea and ureaplasma.

Hepatitis isn't in them, because it's a blood test rather than a swab or urine test. You can add a hepatitis B blood test at the same visit for a small extra cost. If you're not sure what you need, ask us when you come in.

Sister LindiweRegistered Nurse, Observatory, Cape Town

The Small panel at R1,235 covers 4 of the most common silent infections: chlamydia, gonorrhoea, herpes type 2 and trichomoniasis. There's no doctor's consultation fee, so you skip paying for a GP visit just to get a form. Show your Varsity Vibe ID for 10% off, and anything over R1,200 can be split into 4 interest-free instalments with Payflex.

If you can stretch to the Medium at R1,580, it adds HPV, herpes type 1, Mycoplasma genitalium and ureaplasma, which are the ones a cheap screen misses.