STI Testing and Treatment

Medically reviewed by David Shusterman, MD · Updated September 16, 2026

Sexually transmitted infections are common, frequently silent, and rising in incidence across most of the United States. Syphilis in particular has increased markedly, including congenital syphilis, which is the clearest possible signal that testing is not reaching the people who need it. Most people who have one do not know.

We test and treat for chlamydia, gonorrhea, trichomonas, syphilis, HIV, herpes, hepatitis B and C, and HPV-related disease, for men and women, with or without symptoms, in the office or through our virtual clinic.

Testing the right sites

This is the most common technical failure in STI testing and it is worth being specific about. Chlamydia and gonorrhea infect the throat and rectum as well as the genital tract, and those infections are usually asymptomatic. A urine test alone will miss them entirely.

For anyone who has had oral or receptive anal sex, throat and rectal swabs should be included, and they can be self-collected, which most patients prefer. Not offering them is how a substantial share of infections stay undetected and keep circulating. We ask about exposure sites directly and without ceremony, because that is what determines which tests get sent.

Treatment

Chlamydia is treated with doxycycline, which has replaced single-dose azithromycin as the preferred regimen because it works better, particularly for rectal infection. Gonorrhea is treated with an intramuscular ceftriaxone injection, given here — the dose was increased in recent guidance in response to resistance, and oral alternatives are no longer adequate. Trichomonas is treated with an oral regimen that differs between men and women. Syphilis is treated with penicillin, with the number of doses depending on the stage, and staging matters. Herpes is managed with antivirals either episodically or suppressively, and suppressive treatment reduces transmission to a partner.

Partner treatment is part of the treatment, not an afterthought. New York permits expedited partner therapy for chlamydia and gonorrhea, meaning we can provide treatment for a partner who cannot come in. Untreated partners are the single most common reason an infection returns weeks later.

Prevention worth raising

HPV vaccination prevents the cancers HPV causes — cervical, anal, oropharyngeal and others — and is approved through age forty-five. Many adults assume they are too old or that it is only for girls; both beliefs cost people cancers. It is worth a direct conversation.

HIV pre-exposure prophylaxis is highly effective and considerably under-prescribed relative to the number of people who would benefit. Doxycycline taken after exposure has been shown to reduce bacterial STIs substantially in men who have sex with men and transgender women, and is now recommended in that setting; the evidence in other groups is weaker and we discuss it honestly. Hepatitis B vaccination is checked, because many adults were never vaccinated.

How we handle it

Without ceremony. The questions we ask are the ones that determine which tests to send, and they are asked the same way we would ask about anyone's medications. Results come to you directly rather than being left in a portal to find, and anything positive is acted on the day it returns. If you would rather start by video, that is available and is how most of these visits now begin.