What You Need to Know About STI Testing (in the Middle East)

Sex

Stigma surrounding female bodies and sexual activity frequently impedes access to crucial resources and information, particularly about sexually transmitted illnesses (STIs). Despite these challenges, it's essential for women to have an understanding and control over their sexual health.

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We believe in women’s right to access resources and services that help them understand and take control of their sexual health. The reality is, however, that the shame and stigma surrounding female bodies and sexuality in the Arab world often means that women aren’t able to get the answers or the medical support they need. This is especially true in the case of sexually transmitted illnesses (STIs).

Additionally, the lack of sexual education in many Middle Eastern countries often results in a widespread lack of awareness about STIs and their symptoms, making it less likely for individuals to seek testing in the first place.

If you're sexually active, having access to regular STI testing is crucial in allowing you to take control of your overall health. While it's important to acknowledge that, in many parts of the Middle East, women don't have access to safe or confidential testing, it remains essential to gather as much information as possible. So, if you've been curious to find out more, here's what you need to know about STI testing – particularly in the Middle East.

What are STIs?

Sexually transmitted infections, or STIs, are infections that are primarily transmitted through sexual contact. They can be caused by bacteria, viruses, or parasites. Common STIs include Chlamydia, Gonorrhea, Herpes, HIV, HPV, Syphilis, and Trichomoniasis.

Why is STI testing important?

Early detection through STI testing is vital because many STIs don't cause symptoms initially, but they can lead to serious health problems if left untreated. These can include pelvic inflammatory disease, infertility, cancer, and increased risk of HIV infection.

Who should get tested?

Everyone who is sexually active should consider regular STI testing, even if they use protection. Certain factors can increase your risk and may necessitate more frequent testing. These factors include having multiple sexual partners, a history of STI infection, or having sex with someone who has an STI.

In many Middle Eastern countries, socio-cultural norms and legal restrictions may create significant barriers to accessing STI testing services.

Do you need to get tested if you’ve only ever been with your current partner? 

If you are each other’s first partners, or if he was tested at the start of your relationship, then probably not. But there are a few caveats to that statement. 

  1. You should be getting a Pap smear every two years regardless. 
  2. It’s important to be realistic and to acknowledge that infidelity does happen, so if you experience any symptoms that are out of the ordinary, don’t hesitate to get tested. 
  3. We’ve heard – first hand from gynecologists in the Middle East – horrendous tales of both women and men having contracted STIs at a young age through sexual assault. So, even if neither you nor your partner have been in a consensual sexual relationship before, that does not mean that you can’t have been exposed to an STI.

When and how often should you get tested?

The frequency of testing depends on your sexual behavior and individual risk factors. For instance, yearly testing is recommended for sexually active women 25 years and younger and for older women with risk factors such as new sex partners.

What happens during an STI test?

STI testing can involve blood tests, urine samples, or swabs from the genital area or mouth. The type of test will depend on your sexual history and the type of STI being tested for.

How do you prepare for an STI test?

Before your appointment, make a list of your symptoms, sexual behaviors, and any questions you may have. Be honest with your healthcare provider about your sexual history so they can provide the most effective care.

What are the different types of tests?

Here are the most common types of tests done for various sexually transmitted infections (STIs):

Chlamydia and Gonorrhea: These are usually tested together and can be detected through a urine test or a swab from the distal part of the penis or penile secretions in men or from the cervix in women. 

HIV: An HIV test usually involves a blood or saliva sample. Some tests also check for antibodies that your body might make to fight the virus.

Syphilis: The first test for syphilis usually involves a blood test. Further tests may be needed to confirm a diagnosis or to determine the stage of the infection.

Herpes (with symptoms): If sores are present, a swab will be used to collect fluid from the sores and tested. This is the most accurate test if sores or lesions are present.

Herpes (without symptoms): Blood tests can be conducted to look for the herpes virus, but these are not always conclusive.

Human Papillomavirus (HPV): Women are often tested for HPV as part of cervical cancer screenings, which is done through a Pap test or a combination of a Pap test and HPV testing. The test involves collecting cells and fluid from the cervix and vagina for examination.

Hepatitis B & C: These are typically diagnosed with a blood test.

Trichomoniasis: This is usually detected with a physical exam and a swab test in women or Pap smear. In men, the condition is usually diagnosed by identifying the parasite in a urine sample.

What if you test positive?

If you test positive for an STI, remember that many STIs are curable, and that all are treatable. Your healthcare provider will explain your treatment options. You also have a responsibility to inform your sexual partner. This might not be the most comfortable or easy conversation to have, but it will help prevent the spread of the illness and make your treatment more effective. 

What if you’re in a monogamous relationship?

This is a tricky one indeed. The best advice we can give you is to approach this conversation from a place of honesty and vulnerability. 

Can STIs be detected immediately after exposure?

The time between exposure to an STI and when it can be accurately detected is called the "window period." This period varies depending on the STI. For instance, HIV may take up to 3 months to be detected, while Chlamydia and Gonorrhea can usually be detected after 2 weeks or less. Consult with your healthcare provider to understand the best time for testing based on your situation.

How reliable are STI tests?

STI tests are generally quite reliable, but no test is 100% accurate all of the time. False positives and negatives can occur. Some tests may require a follow-up test for confirmation. Also, remember that a negative result does not imply future protection against STIs.

Is at-home STI testing effective?

Home STI testing kits provide privacy and convenience. They require you to collect a sample, which could be urine, blood (via finger prick), or a genital swab. 

As for their effectiveness, we’ve received different answers to this question depending on who we’ve asked and, more specifically, depending on which test is being done or which sample is being collected. 

In general, home testing can provide a good first screening. However, if you test positive, you’ll need to see a doctor to confirm the diagnosis and receive proper treatment. If you test negative but are exhibiting all the symptoms of an STI or have been with a partner who tested positive, it’s important to go in for an in-person test with your healthcare provider. 

If you’re looking for a home test provider, there are a number of services which can bring STI testing to the privacy of your home. If you choose to work with one, please keep in mind that home tests may not be as accurate as tests done in a laboratory setting. One example of a company offering this service is OMGyno.

Can you get an STI test in the Middle East?

The short answer is yes. The long answer is a bit more complex than that, especially if you’re unmarried. In fact, we’ve lost count of the stories we’ve heard of women wearing a fake wedding band in order to get tested.  

In many Middle Eastern countries, socio-cultural norms and legal restrictions may create significant barriers to accessing STI testing services. This is largely due to the prevailing cultural expectation that sexual activity should only occur within the confines of marriage. Therefore, seeking STI testing can carry a heavy stigma and even risk legal repercussions. In some countries, doctors are even legally obligated to report cases of extramarital sexual activity, which can deter people from seeking necessary care.

Women we’ve spoken to in Saudi have told us that they’ve traveled to the UAE to get tested in labs or clinics that offer confidential tests. Another option for some has been finding a trustworthy healthcare professional who keeps women’s identity confidential or assigns them pseudonyms. 

Today, there are a number of NGOs and health initiatives, like Marsa in Lebanon, working tirelessly to challenge these barriers and improve access to sexual health services across the region. They provide confidential and non-judgmental STI testing and counseling, aiming to empower individuals to take control of their sexual health. 

Societal norms are slow to change, but we hope that learning and talking about STIs can help challenge the stigma and misconceptions around them, paving the way for a different reality. 

A final note

Remember that, while STI testing is crucial, prevention remains the best medicine, especially if accessing tests and treatment is going to be difficult for you. This includes using condoms correctly and consistently, getting vaccinated for Hepatitis B and HPV if eligible, and having an open channel of communication with your partner around safe sex. 

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