What Is Included in an STI Panel?

What does a standard STI panel typically include?

Most baseline panels — whether from a primary care clinic, sexual health clinic, or at-home kit — include these four:

• Gonorrhea and chlamydia: usually tested together from a urine sample or genital swab using a highly sensitive NAAT (nucleic acid amplification test) 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.Standard panel components, herpes testing caveats, trichomoniasis testing, hepatitis screening indications, site-specific rectal and pharyngeal swabs, and MSM testing frequency2Ref 2US Preventive Services Task Force; Davidson KW, Barry MJ, Mangione CM, et al. (2021).Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement.USPSTF screening recommendations for chlamydia and gonorrhea by age and risk, and use of NAAT as the most sensitive testing method
• Syphilis: a blood test; often asymptomatic and easily missed without screening 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.Standard panel components, herpes testing caveats, trichomoniasis testing, hepatitis screening indications, site-specific rectal and pharyngeal swabs, and MSM testing frequency
• HIV: a combination antigen/antibody blood test, which detects infection earlier than older antibody-only tests 3Ref 3US Preventive Services Task Force; Owens DK, Davidson KW, Krist AH, et al. (2019).Screening for HIV Infection: US Preventive Services Task Force Recommendation Statement.USPSTF HIV screening recommendation for all adults 15-65 and for those at higher risk, and preference for combination antigen/antibody testing

These four are included because they are common, frequently cause no symptoms, and have serious consequences if missed — and because all are highly treatable when caught 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.Standard panel components, herpes testing caveats, trichomoniasis testing, hepatitis screening indications, site-specific rectal and pharyngeal swabs, and MSM testing frequency.

Which infections are often not on a standard panel — and why that matters

Several important infections may be absent from a routine panel:

Herpes (HSV-1 and HSV-2): Blood tests for herpes exist but are controversial for routine asymptomatic screening because of the complexity of positive results and the frequency of false positives with some assays 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.Standard panel components, herpes testing caveats, trichomoniasis testing, hepatitis screening indications, site-specific rectal and pharyngeal swabs, and MSM testing frequency. Clinicians generally test for herpes when there are visible sores or symptoms. If you have symptoms, ask for a swab of the active lesion.

Hepatitis B and C: Blood tests recommended for certain groups — hepatitis C at least once for all adults, and more frequently for those with injection drug use history or other risk factors 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.Standard panel components, herpes testing caveats, trichomoniasis testing, hepatitis screening indications, site-specific rectal and pharyngeal swabs, and MSM testing frequency. Hepatitis B testing and vaccination status review are also recommended for unvaccinated individuals.

Trichomoniasis: A common STI, particularly common in women, that is often overlooked unless a swab is taken during a pelvic exam or a specific NAAT is ordered 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.Standard panel components, herpes testing caveats, trichomoniasis testing, hepatitis screening indications, site-specific rectal and pharyngeal swabs, and MSM testing frequency.

HPV: There is no approved routine blood test for HPV in adults. HPV is detected through cervical cancer screening (Pap smear or co-test with HPV test) in people with a cervix 4Ref 4Meites E, Szilagyi PG, Chesson HW, Unger ER, Romero JR, Markowitz LE (2019).Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices.HPV vaccine age recommendations and absence of routine HPV blood testing for screening purposes. HPV vaccination is recommended through age 26 for all adults, and may be considered up to age 45 after a discussion with a clinician 4Ref 4Meites E, Szilagyi PG, Chesson HW, Unger ER, Romero JR, Markowitz LE (2019).Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices.HPV vaccine age recommendations and absence of routine HPV blood testing for screening purposes.

Site-specific testing — the detail most people miss

If you have had anal or oral sex, a urine sample or single genital swab alone will miss infections at those sites 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.Standard panel components, herpes testing caveats, trichomoniasis testing, hepatitis screening indications, site-specific rectal and pharyngeal swabs, and MSM testing frequency. Gonorrhea and chlamydia in the rectum require a rectal swab; in the throat, a throat swab. Many clinics do not collect these automatically — you need to mention those exposures so the right sites are sampled.

This is standard clinical information for a sexual health provider to receive. Being specific leads directly to more accurate results. Missing a rectal or pharyngeal infection is a real consequence of not mentioning the relevant exposure.

How often should you get tested?

The USPSTF recommends screening for chlamydia and gonorrhea for all sexually active women under 25 and for older women at increased risk 2Ref 2US Preventive Services Task Force; Davidson KW, Barry MJ, Mangione CM, et al. (2021).Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement.USPSTF screening recommendations for chlamydia and gonorrhea by age and risk, and use of NAAT as the most sensitive testing method. For HIV, the USPSTF recommends screening for all adults ages 15 to 65 at least once, and more frequently for those at higher risk 3Ref 3US Preventive Services Task Force; Owens DK, Davidson KW, Krist AH, et al. (2019).Screening for HIV Infection: US Preventive Services Task Force Recommendation Statement.USPSTF HIV screening recommendation for all adults 15-65 and for those at higher risk, and preference for combination antigen/antibody testing.

For people with multiple or new partners, annual testing for gonorrhea, chlamydia, syphilis, and HIV is a reasonable minimum. For men who have sex with men, the CDC's STI treatment guidelines recommend more frequent testing — every three to six months — including rectal and pharyngeal sites 1Ref 1Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA (2021).Sexually Transmitted Infections Treatment Guidelines, 2021.Standard panel components, herpes testing caveats, trichomoniasis testing, hepatitis screening indications, site-specific rectal and pharyngeal swabs, and MSM testing frequency.

Anyone who has never been tested, or whose last test predates a new partner, belongs in the 'test now' category. Your clinician can help set a schedule based on your specific history and risk profile.

At-home kits compared to clinic testing

At-home STI kits have meaningfully expanded access to screening and are a real option when visiting a clinic is a barrier 5Ref 5National Library of Medicine (2023).Sexually Transmitted Infection (STI) Tests: MedlinePlus Medical Test.Overview of at-home STI testing options and their limitations as a patient-education resource. Most cover the core four (gonorrhea, chlamydia, syphilis, HIV) using urine and finger-stick blood samples. They generally do not include rectal or throat swabs, and positive results always require follow-up with a clinician for confirmation and treatment.

A clinic visit — especially with a provider who knows your history — still offers the most complete and personalized evaluation. At-home testing is a lower-barrier alternative, not an equivalent replacement.