Standard Asymptomatic Check-up


  • To determine risk take a sexual history.
  • Some subpopulations (e.g. men who have sex with men, sex workers, pregnant people, Aboriginal and Torres Strait Islander people, trans and gender diverse people) have special requirements for testing due to increased risk of infection, adverse health outcomes, community prevalence or other factors.
  • Perform asymptomatic sexually transmitted infection (STI) check for people who:
    • request STI testing.
    • are at increased risk of STI: new sexual partner, living or travelling to areas of higher prevalence in Australia or in other countries.
    • have a known exposure to any STI or history of an STI within the past 12 months.
    • are a partner of special subpopulation (listed above) or any of above.

All STI testing should include both HIV and syphilis testing.

Test

Consideration

HIV (antigen/antibody test)

Repeat if recent exposure (6-week window period if Ag/Ab test).

Syphilis serology

If recent exposure, repeat at 12 weeks and presumptively treat.

Hepatitis B:

HBsAg – Hepatitis B surface antigen
Anti-HBs – Hepatitis B surface antibody 
Anti-HBc – Hepatitis B core antibody 

Establish hepatitis B virus (HBV) status and immunise if not previously documented*.

*In Australia, routine adolescent Hepatitis B immunisation commenced in 1997 and universal infant Hepatitis B immunisation commenced in May 2000. Therefore people who are 34 years old or younger in 2020 and who grew up in Australia can generally be assumed to have been vaccinated and do not need testing.

Site/Specimen

Test

Consideration

Urethral first pass urine (FPU)

Self-collected vaginal swab

Nucleic Acid Amplification Test   (NAAT)

Vaginal swab is more sensitive than FPU and is the specimen of choice.

If speculum examination is indicated then an endocervical swab can be collected in place of a vaginal swab.

Specimen collection guidance

Clinician collected | Self-collection

Patients with a positive gonorrhoea NAAT test should be recalled for treatment and, at the same visit, specimens for gonorrhoea culture for antibiotic sensitivity should be collected

Extragenital swabs (pharyngeal swab and self-collected anorectal swab) are not routinely collected in women but may be indicated in women at increased risk of infection, including sexual contacts of gonorrhoea and chlamydia or in sex workers.

Asymptomatic screening is not recommended for the following, unless indicated by other population group guidelines: