Gonorrhoea (throat/anal) Chlamydia (urine/anal) Hepatitis A (consider vaccination †) Screening guidelines for different populations *Ĭhlamydia (cervix/urine) Hepatitis B (consider vaccination †)Ĭonsider annual screening for those who have changed partner, more frequently depending on risk In Australia it is estimated that up to 25-30% of people are seropositive for herpes simplex virus type 2 and 80% are seropositive for herpes simplex virus type 1. Infection is common and often asymptomatic. Genital herpes is the clinical manifestation of infection with either herpes simplex virus type 1 or herpes simplex virus type 2 at genital sites. Culture is also labour intensive, technically difficult and has a long turnaround time. Culture also allows for antibiotic sensitivity testing, but has the disadvantage of relatively low sensitivity and high cost. Although these tests can be used to analyse samples from other sites, such as rectum and vagina, the results should be interpreted with caution.Ĭhlamydia trachomatis cultures are the test of choice if the results are to be used in legal investigations as culture has a high specificity. However, these tests have only been validated for use in urine, cervical and urethral samples. 4Ī positive result from a chlamydia nucleic acid amplification test is likely to be a true positive. One study evaluating nucleic acid amplification tests of self-collected vulval-introital specimens, first void urine samples and clinician-collected cervical samples found the self-collected swabs and urine specimens to be acceptable alternatives to cervical sampling.

3These tests allow non-invasive and self-collected sampling. The chlamydia PCR is highly specific (99-100%) with a sensitivity of 85-90%. In Australia, nucleic acid amplification tests - polymerase chain reaction (PCR) and ligase chain reaction (LCR) - are accurate and reliable. Screening is recommended for all sexually active individuals younger than 25 years regardless of condom use. 2If untreated, chlamydia may have serious sequelae such as pelvic inflammatory disease, ectopic pregnancy and infertility in women, and epididymitis, chronic prostatitis and urethral strictures in men. 1In up to 80% of women and 50% of men the infection is asymptomatic. This period must be considered when interpreting results.Ĭhlamydia trachomatis is the most commonly notified sexually transmitted infection in Australia and rates have risen four - fold between 19. With most infections there is a 'window period' ( Table 2) before laboratory tests become positive. Homosexually active men should routinely have additional tests for both syphilis and hepatitis A. Testing for hepatitis B should be considered for those who have not been vaccinated. Serology for HIV should be considered for all patients. Pretest counselling and education are important. Sexual activity such as vaginal, anal or oral sex will direct from where to collect specimens. To determine which tests to perform, consider the patients' individual needs and concerns, sexual activity, condom use, local epidemiology and any symptoms ( Table 1). As many common sexually transmitted infections, such as chlamydia, are largely asymptomatic, doctors need to be aware of local epidemiology and at-risk groups, in order to facilitate opportunistic screening. This risk is determined by factors such as the use of condoms and the number of sexual partners.

Effective testing for sexually transmitted infections needs to be acceptable to the patient and tailored and targeted appropriately to sexual risk.

Western blot herpes test