As part of their routine care, most women receive Pap smears on a regular basis. For this test, your gynecologist takes a scraping of cells from the surface of your cervix during a pelvic exam. The intent of the Pap smear is to look for certain abnormalities in cells of the cervix, which could indicate that cervical cancer is developing. When precancerous changes are found, these can be treated before they develop into cervical cancer. The widespread use of Pap smears has greatly decreased the number of deaths from cervical cancer.
Many women wonder if their Pap smear also looks for STDs, like HIV. Can HIV be detected in a Pap smear? What about other STDs?
Can a Pap smear detect HIV?
A Pap smear actually can’t detect HIV. The Pap smear takes a sample of cells from the surface of the cervix, and this isn’t where HIV lives. To test for HIV, you need a blood test.
If you’re concerned about possibly having HIV, then you can talk to your gynecologist about it when you go for your Pap smear appointment. They can order a blood test, and you may get the blood sample taken in their office or at a separate laboratory. Another option is to order a home testing kit, which uses a blood sample obtained by a small fingerprick. The kit is mailed to you, and you take the sample and mail it back to the lab, which then sends you your results online. Keep in mind that if your possible exposure is recent, then you might need to retest again in a few months.
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Does a Pap smear test for STDs?
The Pap smear itself only looks for the changes in cervical cells that can accompany cervical cancer. However, there are certain types of STDs that can be detected in a sample of fluid from the cervix. These include gonorrhea and chlamydia, two of the most common STDs.
When you have your Pap smear, your doctor can take a swab of the cervix at the same time, in order to test for these STDs. This adds hardly any extra time to the Pap smear process. Many gynecologists will ask you if you want to have this test when you get your Pap smear, but if they don’t ask you about it, then you can ask them to swab your cervix for STDs at the same time.
What STDs can be detected by a Pap smear?
There is one STD that is often tested for during a Pap smear. HPV is the one STD diagnosed by a Pap test. Actually, the Pap test itself technically only looks for the cell changes in the cervix, and so HPV is not actually being diagnosed by the Pap test. However, it’s possible to use the same sample to test for certain forms of HPV, and this is commonly done. Your doctor can take just one sample of cells from your cervix, and have this tested both for cell changes and for HPV.
Certain types of HPV are associated with the development of cervical cancer, while others are not. The types that can lead to cancer are known as “high-risk” forms of HPV. On a Pap smear, the sample is often tested for high-risk forms of HPV. The same sample of cells scraped from the cervix can be used for a Pap test, an HPV test, or both.
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Cervical Cancer – What should I know about screening? Centers for Disease Control and Prevention (2021). https://www.cdc.gov/cancer/cervical/basic_info/screening.htm. Accessed 21 April 2022.
HPV and Pap Testing. National Cancer Institute (2019). https://www.cancer.gov/types/cervical/pap-hpv-testing-fact-sheet. Accessed 21 April 2022.
Pap Smear. Cleveland Clinic (2021). https://my.clevelandclinic.org/health/diagnostics/4267-pap-smear. Accessed 21 April 2022.