Can a pap smear detect STDs?

Answer 1

Well, that's a question that has a short answer, and a longer explanation. The pap smear doesn't look for STDs itself, but looks for damage due to high-risk HPV infection. However, it is not uncommon for STD tests to be ordered at the same time.

The purpose of the pap smear is to identify patients who need further testing for cancerous and precancerous changes on the cervix. In the pap smear, a sample of cells is taken from the cervix and a specialist looks at the cells under a microscope (or a computer reads the result). In some cases, the health care provider may also request an test for high-risk (cancer-causing) HPV subtypes with the pap smear. Under the most recent guidelines for Cervical cancer screening, this test is done for women 30 and over, or is added on in the case of a mildly abnormal pap (i.e. an ASCUS result). This test for high-risk HPV subtypes is not meant to tell you that you do or don't have HPV, but is only meant to highlight which patients need a different test schedule based on cancer-causing HPV subtypes.

In the course of collecting a Pap smear, the health care provider can also request that the lab check for STDs. In some cases, a test for STDs such as chlamydia, gonorrhea, and trichomoniasis can be added on to the lab request and tested from the same swab. In other cases, a second swab is sent out for the infections, and a microscopic examination of the vaginal discharge can also be done to check from trichomoniasis.

In rare cases, a pap smear may show infection with trichomoniasis, but a normal pap smear can not be assumed to mean no trich infection. In even rarer cases, a pap may show signs of herpes. Herpes will only show up if there's active infection on the cervix, and a woman with a normal pap smear must not assume that she does not have herpes.

A pap smear cannot detect or rule out HIV, hepatitis, or syphilis. Blood tests are required to screen for these diseases.

In summary:

• A normal pap smear does not tell you anything about your STD status.
• If you would like STD testing, be sure to discuss this with your health care provider; don't assume that testing is being done.
• A pap smear may occasionally detect trichomoniasis or herpes, but a normal pap doesn't mean you don't have these infections.
• HPV testing during pap smears is not meant to tell you if you have now or have ever had HPV; it's only meant to detect high-risk HPV subtypes so that an appropriate screening schedule can be targeted to your needs.
• HPV testing is not done on every pap smear. Ask your health care provider about the cervical cancer testing plan that's appropriate for your age and Pap history.

No, a pap test will not detect a STI infection. It will, though, detect PID which is caused by a STI.
No. You have to ask specifically for those tests.