The answer to whether herpes is included in a standard sexually transmitted disease (STD) test is generally no, unless a person specifically requests it. Routine screening panels are designed to detect infections that are often asymptomatic, easily treatable, and carry significant public health consequences if left undiagnosed. This exclusion is rooted in the unique characteristics of the virus, the limitations of the available tests, and the medical community’s current screening guidelines.
The Scope of Standard STD Panels
Routine STD screening panels are established to target infections that pose the most significant public health threat and benefit the most from early detection. These panels almost always include testing for human immunodeficiency virus (HIV), syphilis, gonorrhea, and chlamydia. Gonorrhea and chlamydia testing is usually performed using a urine sample or a swab, as these are bacterial infections highly curable with antibiotics. Testing for HIV and syphilis requires a blood sample to look for the presence of the virus or specific antibodies. These conditions are included because they can cause severe, long-term health complications if treatment is delayed. The focus is placed on infections that are routinely curable or that require immediate, life-altering management to prevent systemic damage.
Specifics of Herpes Testing and Why It Differs
Testing for herpes differs significantly from the standard panel because the approach depends entirely on whether a person has visible symptoms.
Testing with Symptoms
If active lesions, such as blisters or sores, are present, the most accurate method is diagnostic testing using a swab taken directly from the lesion. This swab is analyzed using a Polymerase Chain Reaction (PCR) test, which detects the virus’s genetic material and can distinguish between HSV-1 and HSV-2.
Testing Without Symptoms
If no symptoms are present, a blood test is used to check for immunoglobulin G (IgG) antibodies, which indicate a past exposure to the virus. This type-specific IgG test can differentiate between HSV-1, which often causes oral herpes, and HSV-2, the most common cause of genital herpes.
Why Routine Screening is Avoided
The primary reason this antibody test is not routine is the complexity of interpreting the results in asymptomatic individuals. A positive result only confirms exposure and does not indicate when the virus was contracted or whether the person will ever experience an outbreak. Furthermore, the blood test can produce false positive results, especially in populations with a low prevalence of the virus, which can lead to unnecessary anxiety. Because the infection is lifelong and often asymptomatic, public health guidelines generally do not recommend routine screening without symptoms or specific risk factors.
When and How to Request Testing
A person should specifically ask for herpes testing whenever symptoms are present, when a partner has tested positive for the virus, or if they have a generalized concern about a potential exposure. Clear communication with a healthcare provider is necessary, as simply asking for a “full panel” may not include the appropriate test for herpes.
If a person has a blister or sore, they should request a viral swab or PCR test to confirm if the lesion is caused by HSV. This diagnostic test provides the most accurate result for an active infection. If a person has no symptoms but is concerned about past exposure, they should request a type-specific IgG blood test. IgG antibodies can take up to 12 to 16 weeks to reach detectable levels in the blood after initial exposure, meaning testing too early can result in a false-negative result. Being honest about recent sexual history allows the provider to determine the correct test and the optimal time frame for collection.