Barriers to STD Testing in Men: Insights from Mark Kruzel, MD
Author(s): Scott Douglas Jacobsen
Publication (Outlet/Website): A Further Inquiry
Publication Date (yyyy/mm/dd): 2025/09/29
Mark Kruzel, MD, MBA, is Medical Director of questhealth.com (the consumer-initiated testing arm of Quest Diagnostics). He previously served as Associate Medical Director in Oncology at Quest, where he bridged assay development and clinical utility, guided molecular oncology adoption, and led payer access strategies. Dr. Kruzel holds an MD from the University of Texas McGovern School of Medicine and an MBA from SMU’s Cox School of Business. He is passionate about empowering individuals to take charge of their health through accessible, physician-guided diagnostic insights.
In this interview with Scott Douglas Jacobsen, Kruzel discusses why many men hesitate to ask providers about STD testing. Stigma, shame, and less routine engagement with the healthcare system are key obstacles. Long wait times and a perceived lack of provider initiative further suppress patient inquiry. Generational shifts show young men are more willing to talk about sexual health than Boomers or Gen X. Kruzel stresses that many STIs are asymptomatic and urges men to consider using discreet, physician-ordered lab testing platforms like questhealth.com.
Scott Douglas Jacobsen: What are the primary barriers preventing men from asking their healthcare providers about STD testing?
Mark Kruzel, MD: Research suggests both men and women may feel stigma and even shame about being tested for an STI, but women tend to have more routine engagement with the healthcare system than men, including for STDs. For instance, the CDC recommends screening women under the age of 25 for chlamydia and gonorrhea. In contrast, many men do not have regular engagement with the healthcare system and may not be subject to periodic screening under current guidelines.
As Quest’s 2025 Know Your Health Survey found, nearly one-third of Americans (30%) surveyed agree their healthcare team does not take the time to discuss prevention and wellness with them. Plus, nearly 2 in 5 Americans (39%) report having to wait more than three months to see a healthcare professional for a potential health concern. When long wait times are combined with feelings of shame or discomfort around STD testing, many individuals may choose not to bring up their concerns at all with a provider.
Jacobsen: Are there generational differences in attitudes about sex health conversations (ex. Boomer men compared to Gen Z men)?
Kruzel: As one would expect, the survey revealed notable generational differences in attitudes towards sexual health. Historically, sexual health has been a taboo subject, especially for Baby Boomers and Gen Xers.
Only 28% of Gen Xers and just 12% of Boomers will ask a partner about their STD status before being intimate. That compares to 57% of Gen Z and 59% of Millennials. We’ve found that individuals 35 years old and younger are the most apt to order STI screening tests.
It’s also important to note that we know more about STDs than we did several years ago. Two decades ago, providers were not screening for conditions like trichomoniasis or Mycoplasma genitalium (or M-gen), which can cause pelvic inflammatory disease and infertility. Fortunately, the CDC and other medical advisory bodies provide guidelines recognizing the value of screening for these and other conditions, like hepatitis C, that can be transmitted sexually. Both men and women should consult their doctors about whether testing is appropriate for them.
Jacobsen: Quest’s Know Your Health Survey notes that 36% of men are influenced by social media health stories. Do influencers and platforms that promote medical information have a responsibility to convey accurate facts?
Kruzel: One of the concerning findings from our survey was that about 1 in 4 Americans (24%) admit they get advice about health topics from social media influencers. But not all influencers have medical training, and certainly they can’t provide counsel for an individual patient.
At Quest, we’re committed to promoting responsible, fact-based digital health education. All our tests and supporting content on questhealth.com are reviewed and approved by a team of medical professionals, and a physician is available to discuss findings.
Jacobsen: How is Quest adapting its services to meet the demand for discreet sexual health testing?
Kruzel: Quest strives to create a judgment-free and confidential environment that is easily accessible, ultimately empowering individuals to take control of their health without stigma or inconvenience. STD/STI testing is the most popular lab test category on questhealth.com, and STD testing is among our most commonly ordered offerings. Many of these tests provide a pathway to treatment, should results require care. No doctor visit is required for questhealth.com purchases, although a physician orders each test and is available to discuss results.
Jacobsen: What are the most common misconceptions about STIs among men?
Kruzel: One of the most common myths is that STIs always cause noticeable symptoms. While that’s true in many cases, STIs are asymptomatic, potentially putting both you and your partner at risk. In fact, up to 50% of men and 90% of women with chlamydia don’t show symptoms, and about 80% of women with gonorrhea have no symptoms.123 The only way to know for sure if you have an STD is to get tested. You can be tested through your doctor or engage in consumer-initiated tests, like questhealth.com, where you can access the same lab tests doctors use but without having to first visit a doctor. Overall, education remains key to changing these narratives.
Jacobsen: What is the role of masculinity norms and stigma in the underutilization of sexual health services?
Kruzel: Our survey found that 41% of men always or have always asked a partner about their STD status before being intimate, compared to only 33% of women. While sexual wellness may not rank as the top healthcare priority for many men, nearly half are taking clear steps to prioritize their sexual health.
Jacobsen: How do demographic disparities (such as race, income, or region) impact the underutilization of sexual health services, if at all?
Kruzel: Some communities face limited access to care, insurance barriers, and historical mistrust of the healthcare system. Our Quest survey, for instance, found that more than 1 in 3 Americans (37%) have reported experiencing barriers to receiving medical care in the past 12 month and nearly one in 10 (9%) said they did not seek medical care because they were afraid their insurance wouldn’t cover enough of their medical expenses (9%).
Jacobsen: How can public health campaigns foster long-term behavioral change in sexual health practices?
Kruzel: 1 Farley TA, Cohen DA, Elkins W. Asymptomatic sexually transmitted diseases: the case for screening. Preventive medicine 2003;36:502.
2 Korenromp EL, Sudaryo MK, de Vlas SJ, et al. What proportion of episodes of gonorrhea and chlamydia becomes symptomatic? International journal of STD & AIDS 2002;13:91-101.
3 Hook EW, III, Handsfield HH. Gonococcal infections in the adult. In: Holmes KK, Sparling PF, Stamm WE, et al., editors. Sexually Transmitted Diseases. 4th ed. New York: McGraw-Hill; 2008. (Gonorrhea infection in women: prevalence, effects, screening, and management (nih.gov))
Kruzel: Reducing stigma and shame is critical. Messages should be paired with clear, actionable steps and accessible services. Improving access to screening is also critical. For instance, in recent months, Quest has rolled out several options for women to self-collect specimens for testing for STIs and other conditions related to genital tract infections at the company’s 2,000 patient service centers to help improve screening.
Jacobsen: Thank you for the opportunity and your time, Mark.
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