When an STD test result includes the phrase “will follow,” it signals an incomplete testing process, often causing immediate concern. This notation is a technical communication indicating the initial screening test requires further investigation. The phrase means a second, more definitive testing step is underway or needs to be ordered to finalize the diagnosis. This is not a confirmed positive result, but an indication that the initial screen detected something warranting a closer look. This delay is a standard part of the diagnostic process designed to ensure the highest accuracy before a final diagnosis is made.
Understanding Preliminary Screening Results
The appearance of “will follow” is tied to the result of the initial screening test. Screening tests, such as an enzyme immunoassay (EIA), are designed to be extremely sensitive, casting a wide net to catch potential signs of infection. These tests look for antibodies or specific viral antigens in the sample. Results are reported as “non-reactive” (no indication of infection) or “reactive” (a signal was detected).
A reactive result suggests the target substance was present above a certain threshold. However, this finding is insufficient for a diagnosis because high sensitivity can lead to a “false reactive” result. This is why the result is preliminary and followed by the “will follow” note. Sometimes, the result is “indeterminate,” meaning the test returned a weak or ambiguous signal that also requires confirmation.
The Rationale for Confirmatory Testing
Healthcare protocols mandate a two-step process for specific STDs, such as HIV and syphilis, primarily to manage the risk of a false positive diagnosis. Screening tests are designed with high sensitivity to reduce the chances of missing a true infection (a false negative). A highly sensitive test identifies nearly every infected person, but the trade-off is often lower specificity. Lower specificity means the test might react to something other than the target infection, leading to a false positive result for an uninfected person.
Follow-up testing is necessary because a false positive diagnosis can have serious emotional, social, and medical consequences for a patient. Confirmatory tests are chosen for their high specificity, ensuring the detected signal truly originates from the specific STD. By requiring a highly specific test to confirm the finding of a highly sensitive test, the diagnostic process minimizes the chance of both false negatives and false positives.
The Mechanics of Follow-Up Testing
Once an initial screening result is reactive or indeterminate, the laboratory automatically initiates the confirmatory testing process. This second test typically employs a different, more complex methodology than the initial screen, such as a Western Blot, an immunofluorescence assay, or a Nucleic Acid Test (NAT), depending on the specific infection. These specialized methods analyze the sample with greater precision to positively identify the presence of the infection’s genetic material or a unique pattern of antibodies. The process is often performed on the original sample, meaning a patient usually does not need to return for a second collection.
The specialized nature of these confirmatory assays means the turnaround time is generally longer than the initial screen. While a rapid screening test might yield results in minutes, the definitive follow-up test can take anywhere from a few days to a week or more to process. The exact timeline depends on the specific STD, the complexity of the test method, and the workload of the specialized reference laboratory.
Interpreting the Final Result
Once the “will follow” period concludes, the healthcare provider will communicate one of three possible final outcomes to the patient.
The most reassuring outcome is a Confirmed Negative result, which means the confirmatory test did not verify the initial reactive finding. In this scenario, the preliminary result was a false alarm, and the patient does not have the infection. The patient can then proceed with standard health counseling.
The second outcome is a Confirmed Positive result, indicating that the initial reactive screen was accurate and the patient is infected. This result triggers immediate action, including counseling, linkage to medical treatment, and mandatory reporting to public health authorities. The focus then shifts to starting timely treatment and discussing prevention strategies.
The final possibility is an Indeterminate or Inconclusive final result, which means the confirmatory test could not produce a clear positive or negative answer. This can happen if the infection is very new and the body’s immune response is still developing, or due to cross-reactivity. In this case, the next step is typically to retest the patient after a short waiting period, often two weeks, to allow the infection markers to reach a detectable level.