“Doctor, I found out yesterday that my boyfriend visited a sex worker. We had sex last week. I’m scared and confused—what tests should I get?” In last week’s clinic, 25-year-old Xiao Lin asked this with reddened eyes — this is not isolated. Many women in this situation are first overwhelmed by emotion, then either forget to get proper health checks or end up having a random array of tests. Today, as a gynecologist, I’ll help you sort out the priorities: do tests in 3 steps so you don’t miss risks or waste money, protect your own health first, then deal with other issues.

First clarify the core: visiting sex workers increases the risk of sexually transmitted infections (STIs) and may also lead to gynecological infections. Testing should be staged and focused—don’t panic blindly, but don’t be complacent either.

Step 1: Immediate screening (within 1–3 days of discovery): first prevent “acute infections”

This stage focuses on testing for sexually transmitted infections and gynecological infections that “have rapid onset and obvious symptoms”; early detection and treatment prevent worsening:

Vaginal discharge routine + Neisseria gonorrhoeae / Chlamydia testing

What it tests for: screening for trichomonas vaginitis, bacterial vaginosis, and gonorrhea and chlamydia infections (the latter two are common STIs associated with visiting sex workers and often accompany abnormal vaginal discharge and urinary frequency/urgency);

Why urgency is needed: if gonorrhea or chlamydia infections are not treated promptly, they can ascend and cause pelvic inflammatory disease, and even affect the fallopian tubes (leading to infertility);

Note: Do not have intercourse or use douche solutions within 24 hours before sampling, otherwise results may be affected.

Xiao Lin tested positive for chlamydia, promptly took antibiotics for 7 days, and retested negative after 2 weeks with no sequelae.

External genitalia / urethral meatus examination

The physician will visually inspect the external genitalia, vaginal introitus, and urethral meatus for redness, ulcers, or small nodules (to rule out primary syphilitic chancre and early condyloma acuminatum).

If there is slight redness or swelling or itching, you can temporarily wash with warm water; do not apply ointment. Wait for the test results before providing targeted treatment.

Step 2: Follow-up after the window period (4–8 weeks after discovery, crucial!): detect “latent STIs”

Many sexually transmitted infections have a "window period" (a time after infection when tests cannot detect it). You must wait until the window period has passed before testing, otherwise false negatives may occur:

Syphilis serologic testing (TPPA + RPR)

Window period: 4–6 weeks after infection. If the first test is negative, repeat once at 3 months (to avoid missed diagnosis);

What to test: To determine whether syphilis infection is present (visiting sex workers is a high-risk factor). RPR can also assess the severity of infection;

Reminder: Early-stage syphilis (primary chancre phase) is easy to treat; if delayed to late stages it can damage the nervous system and heart. Do not wait for symptoms before testing.

HIV antibody test (HIV-Ab)

Window period: For most people 3–4 weeks; to be safe it is recommended to test after 6 weeks. If negative, repeat once at 3 months (to definitively rule out infection);

Why it matters: HIV is asymptomatic in the early stage but can be transmitted through sexual intercourse; early detection and early intervention can control disease progression.

Condyloma acuminatum screening

Window period: 2 weeks to 8 months (average 3 months); during this time, watch for cauliflower-like or papillomatous small nodules on the vulva and perianal area;

If you find nodules, do not pick at them yourself; promptly go to the dermatology and venereology clinic for laser or cryotherapy, and have your boyfriend tested as well (to avoid cross-infection).

Step 3: Gynecological specialized examination (1–3 months after discovery): guard against “long-term risks”

In addition to acute STIs, pay attention to cervical health (HPV infection, cervicitis); these are the “long-term risks” that commercial sex work may bring:

Cervical TCT + HPV testing

What it checks: TCT examines whether cervical cells are abnormal; HPV testing checks for infection with high-risk virus types (commercial sex increases the risk of HPV cross-infection, particularly types 16 and 18);

Recommendation: If results are normal, have regular annual screenings; if HPV is positive, follow the previously provided "clearance and recovery checklist" and retest in 6 months; if TCT is abnormal, perform further colposcopy.

Mycoplasma testing (optional, if there is frequent urination or increased vaginal discharge)

Mycoplasma infection may be asymptomatic but can cause increased vaginal discharge and discomfort during intercourse. If these symptoms are present, testing can be done; if positive, follow the physician’s treatment recommendations (some people do not require treatment—this should be determined by a doctor).

Three things you must do after testing: don’t let your health be “secondarily harmed”

Suspend sexual intercourse until all tests are negative

Having sex before completing testing may cause you to be reinfected, and may also transmit the STI to your partner (even if you have not yet been diagnosed);

If your boyfriend is also tested, both of you should be fully treated before considering resuming sexual intercourse (use condoms throughout, for at least 3 months).

Don’t "give up on yourself," and don’t self-medicate blindly

Many people become anxious, have insomnia, or take “immune-boosting” supplements recklessly because of their boyfriend’s mistake. In fact, keeping a regular routine (sleeping 7 hours per night) and eating more eggs and milk (to supplement protein) is more helpful than supplements;

Medications must follow the doctor’s orders (especially antibiotics and antivirals); do not buy "miracle STD drugs" online to avoid resistance or liver damage.

Communicate rationally and set clear boundaries

After the test results come back, have an honest conversation with your boyfriend (make him also do the full set of tests). If he refuses testing or is dismissive, you need to reconsider the relationship — health is more important than a romance; don’t sacrifice yourself to accommodate him.

Finally, I want to say: if you discover your boyfriend is soliciting sex workers, you may feel angry and disappointed, but please set aside the emotions for a moment and follow the steps for testing — your health is yours and no one else can assume that risk for you. Even if a problem is found, don’t panic; most STDs (syphilis, chlamydia, HPV) can be treated if detected early. The key is not to delay and not to miss any tests.

If you are currently in a state of chaos, first bookmark this article and go to a reputable hospital tomorrow to register at the gynecology or dermatology-and-venereology department (do not go to a private clinic). Follow these three steps for examinations — protecting yourself is the most important thing to do right now. What you need now is a practical guide on “which tests to take after discovering your boyfriend has been soliciting sex.” I have approached this by scenario and organized the testing logic by stage, covering urgent screening, window-period re-testing, and long-term gynecological risks, and I have also added post-test protective recommendations and emotional support. If you think a stage’s testing needs further detail (for example, specific medication dosages or differences in testing procedures between hospitals), or want to add communication techniques for “how to persuade your boyfriend to get tested together,” tell me and I will further adjust the content.