How to Read Your STD Test Results

An STD test report can be short on explanation. Here is how to read the common wording, and what each kind of result usually leads to. Only the clinician who ordered your test can tell you what your own result means.

How do I read my STD test results?

Look for four things on the report:

1. Which tests were run. A negative applies only to the infections listed.
2. The sample or body site. A urine or genital result doesn’t cover the throat or rectum.
3. The result for each test. This will be negative or positive, or non-reactive or reactive for some screening tests.
4. The date the sample was taken. A result reflects that day, not today.

What do negative and positive results mean?

MedlinePlus puts a chlamydia negative this way: you did not have a chlamydia infection when the sample was collected. A positive means you have been infected with chlamydia.

For HIV, MedlinePlus says a negative means no signs of HIV were found in your sample, but it may be too early to detect an infection. A positive means signs of infection were found in your sample, and a follow-up test is needed to confirm unless you had a NAT test.

For syphilis, MedlinePlus says a negative screen means you probably don’t have a syphilis infection, though it doesn’t completely rule one out. A positive screen means you have antibodies that may be from syphilis. The second step is a confirming test.

What does “reactive” mean?

Some labs report a screening test as reactive or non-reactive instead of positive or negative. Reactive means the screening test found signs of the infection. It is a first step, not a final answer. The CDC says preliminary positive HIV screening tests require supplemental testing to confirm the diagnosis, and that people with a reactive rapid test should be assessed with a laboratory-based antigen/antibody test.

What does an inconclusive or indeterminate result mean?

It means the test couldn’t give a clear answer. For HIV, the CDC says that if acute infection is suspected after a recent exposure and the standard algorithm is negative or indeterminate, HIV RNA testing is recommended. Ask your clinician what an unclear result means for your test and when to repeat it.

How are syphilis and herpes results different?

Syphilis. The CDC says diagnosis uses two types of blood test, one nontreponemal and one treponemal, and that using only one type is insufficient. Nontreponemal test titers are used to monitor treatment response. Treponemal tests usually stay reactive for life, so a positive can remain after treatment.

Herpes. Blood tests look for type-specific antibodies, to HSV-1 or HSV-2. The CDC says false negatives are more likely early in infection, and that low-level positive results can be falsely positive and may need a second test to confirm. See the false-positive guide.

Does a negative result cover everything?

No. It covers the tests you took, at the sites sampled, at that moment. The CDC doesn’t recommend routine herpes screening for the general population, so many routine panels leave it out. If you had oral or anal sex, the CDC says to talk with a health care provider about throat and rectal testing options.

A negative taken too soon after sex also isn’t final. See Negative STD test results: are you in the clear?.

What should I do with my result?

• Negative: retest after the window period if the test was early or you’ve had a new exposure.
• Positive or reactive: follow up with a clinician for confirmation and next steps. Treatment, when needed, is prescribed by a clinician.
• Unclear: ask the ordering clinician or the lab what it means and when to repeat.
• At-home test: the CDC says a positive HIV self-test needs a follow-up with a health care provider. MedlinePlus advises discussing any at-home STI result with your provider.