To determine risk, take a sexual history.
| Tests for all sexually active people <30 years, as well as anyone who identifies themselves at risk. |
|---|
| Infection |
Site / Specimen & Test |
Consideration
|
| Chlamydia (males) |
FPU – NAAT |
Nil
|
| Chlamydia (females) |
Endocervical swab – NAAT |
Best test if examined. |
Self-collection of samples for NAAT testing
Vaginal swab: instruct the patient to insert the swab into the vagina like a tampon and then remove and place into the transport tube.
Rectal swab: instruct the patient to insert the swab into the anal canal 2-4cms and then remove and place into the transport tube.
FPU (First pass urine): Collect approximately 20 ml (1/3 of the standard urine jar) of the first part of the urine stream in a specimen jar at the time you are consulting the patient. The patient does not need to have held their urine for more than 20 minutes prior to specimen collection. A midstream urine (MSU) or early morning specimen (i.e. first void urine) are not required for NAAT.
Click here for information on how to describe self-collection technique to a patient. |
If not examined or patient has had a hysterectomy. |
| FPU – NAAT |
Only if endocervical swab/self-collected vaginal swab cannot be taken. Not as sensitive as
Self-collection of samples for NAAT testing
Vaginal swab: instruct the patient to insert the swab into the vagina like a tampon and then remove and place into the transport tube.
Rectal swab: instruct the patient to insert the swab into the anal canal 2-4cms and then remove and place into the transport tube.
FPU (First pass urine): Collect approximately 20 ml (1/3 of the standard urine jar) of the first part of the urine stream in a specimen jar at the time you are consulting the patient. The patient does not need to have held their urine for more than 20 minutes prior to specimen collection. A midstream urine (MSU) or early morning specimen (i.e. first void urine) are not required for NAAT.
Click here for information on how to describe self-collection technique to a patient. |
| Ano-rectal swab |
If patient has had anal sex or has ano-rectal symptoms.
If patient declines anal examination, instruct
Self-collection of samples for NAAT testing
Vaginal swab: instruct the patient to insert the swab into the vagina like a tampon and then remove and place into the transport tube.
Rectal swab: instruct the patient to insert the swab into the anal canal 2-4cms and then remove and place into the transport tube.
FPU (First pass urine): Collect approximately 20 ml (1/3 of the standard urine jar) of the first part of the urine stream in a specimen jar at the time you are consulting the patient. The patient does not need to have held their urine for more than 20 minutes prior to specimen collection. A midstream urine (MSU) or early morning specimen (i.e. first void urine) are not required for NAAT.
Click here for information on how to describe self-collection technique to a patient. |
FPU – First pass urine
NAAT – Nucleic Acid Amplification Test |
| Consider the following tests for individuals who are not from a high risk population group. To determine risk, take a sexual history. |
|---|
| Infection |
Site / Specimen & Test |
Consideration |
| Hepatitis B |
Blood – HBsAg, Anti-HBs, Anti-HBc
|
Include "? Chronic hepatitis B” in the clinical notes section.
Vaccinate if not immune. Vaccination is free in most states/territories for sexual/household contacts.
|
| HIV |
Blood – HIV Ag/Ab |
Repeat test if patient exposed within previous 12 weeks (window period). |
| Syphilis |
Blood – Syphilis serology |
Nil |
HBsAg – Hepatitis B surface antigen
Anti-HBs – Hepatitis B surface antibody
Anti-HBc – Hepatitis B core antibody
HIV Ag/Ab – HIV antigen/antibody |
| Additional test to consider in asymptomatic individuals. |
|---|
| Infection |
Site / Specimen & Test |
Consideration |
| Gonorrhoea |
See gonorrhoea guideline for testing information |
Gonorrhoea testing only recommended in certain high-risk populations. |
Specimen collection
Clinician collected for NAAT/culture/microscopy
Urethral swabs for microscopy should be collected when the patient has not urinated for at least 1 hour and only if the patient has frank urethral discharge. Squeeze the urethra to express the discharge and collect on urethral swab. It is not necessary to insert the swab into the urethra.
Rectal swabs should be collected by inserting a sterile swab 2-4cms into the anal canal and moving the swab gently side to side for 10-20 seconds.
Pharyngeal swabs should be collected from the tonsils and oropharynx.
High vaginal swab of vaginal discharge smeared onto a glass slide, air dried and sent for microscopy. Swab inserted into transport medium for culture.
Self-collection of samples for NAAT testing
Vaginal swab: instruct the patient to insert the swab into the vagina like a tampon and then remove and place into the transport tube.
Rectal swab: instruct the patient to insert the swab into the anal canal 2-4cms and then remove and place into the transport tube.
FPU (First pass urine): Collect approximately 20 ml (1/3 of the standard urine jar) of the first part of the urine stream in a specimen jar at the time you are consulting the patient. The patient does not need to have held their urine for more than 20 minutes prior to specimen collection. A midstream urine (MSU) or early morning specimen (i.e. first void urine) are not required for NAAT.
Click here for information on how to describe self-collection technique to a patient.
