From the Guidelines
Urine testing with nucleic acid amplification tests (NAATs) is the preferred method for screening chlamydia and gonorrhea due to its high sensitivity and specificity, as well as its non-invasive nature, as recommended by the U.S. Preventive Services Task Force 1. When it comes to STD testing, both urine tests and swabs are effective, but they detect different infections and have distinct advantages.
- Urine tests are generally preferred for chlamydia and gonorrhea screening as they're non-invasive and highly accurate for these common infections.
- Swab tests, which involve collecting samples from the throat, rectum, cervix, urethra, or vagina, are better for detecting herpes, syphilis, HPV, and trichomoniasis.
- They're also necessary when testing specific infection sites like the throat or rectum. The choice between urine and swab testing depends on symptoms, sexual practices, and which infections the healthcare provider suspects.
- Most STD testing can be completed in a single visit, with results typically available within a few days to a week.
- Regular testing is recommended for sexually active individuals, especially those with new or multiple partners, as emphasized by the U.S. Preventive Services Task Force 1. It's essential to consider the communities being served and consult local public health authorities for guidance on identifying groups at increased risk, as gonococcal infection is concentrated in specific geographic locations and communities 1.
From the Research
Comparison of Urine and Swab Samples for STI Testing
- Urine samples can be used to diagnose gonorrhea and chlamydia infections using nucleic acid amplification tests (NAATs), which are highly sensitive and specific 2.
- Self-collected genital specimens, such as urine or vaginal swabs, can be accurately used to diagnose gonorrhea or chlamydia infections, decreasing the necessity for a clinician to perform a pelvic examination 2.
- NAATs can also be used on swab samples, including anorectal and pharyngeal specimens, to diagnose Neisseria gonorrhoeae and Chlamydia trachomatis infections in men who have sex with men 3.
- However, pooling specimens, such as urine, anorectal, and pharyngeal specimens, can reduce test sensitivity to 89.5% 3.
Diagnostic Accuracy of NAATs
- NAATs have high sensitivities (86.1%-100%) and specificities (97.1%-100%) for the diagnosis of gonorrhea, chlamydia, and other STIs 4.
- The use of NAATs for self-collected samples can greatly increase the types and numbers of patients that can be screened outside of clinic settings 2.
- NAATs can be used to diagnose asymptomatic infections, which account for approximately 70% of infections with HSV and trichomoniasis and 53% to 100% of extragenital gonorrhea and chlamydia infections 4.