From the Guidelines
Urine tests can screen for chlamydia and gonorrhea, which are two common sexually transmitted diseases (STDs), as recommended by the US Preventive Services Task Force 1.
Screening for STDs
The USPSTF concludes with moderate certainty that screening for gonorrhea is associated with moderate net benefit in all sexually active females aged 24 years or younger and in older women who are at increased risk for infection 1.
- Chlamydia and gonorrhea testing via urine is particularly common and convenient, as it doesn't require invasive swabbing procedures.
- For optimal results, patients should provide a first-void urine sample (the initial portion of the urine stream) and should not have urinated for at least one hour before collection.
Importance of Screening
It's essential to note that other common STDs like HIV, syphilis, herpes, and HPV cannot be reliably detected through urine testing and require blood tests or physical examinations 1.
- Urine-based STD testing is popular because it's non-invasive, relatively painless, and can be done privately, making it more accessible for people who might otherwise avoid STD screening due to discomfort or embarrassment associated with more invasive collection methods.
Testing Methods
Nucleic acid amplification tests (NAATs) have high sensitivity and specificity and are cleared by the U.S. Food and Drug Administration for use on urogenital sites, including male and female urine, as well as clinician-collected endocervical, vaginal, and male urethral specimens 1.
- The same specimen can be used to test for chlamydia and gonorrhea 1.
From the Research
Sexually Transmitted Infections (STIs) that can be Screened by Urine
- Chlamydia: Urine samples can be used to diagnose chlamydia in women, with a sensitivity of 86.2% and specificity of 98.8% 2
- Gonorrhea: Urine samples can be used to diagnose gonorrhea in women, with a sensitivity of 94.4% and specificity of 99.7% 2
- Trichomoniasis: Molecular diagnostic tests that use urine or self-collected swabs may lead to more screening opportunities and be more acceptable to patients, resulting in faster and more accurate diagnosis and treatment of trichomoniasis 3
- Mycoplasma genitalium: Molecular diagnostic tests that use urine or self-collected swabs may lead to more screening opportunities and be more acceptable to patients, resulting in faster and more accurate diagnosis and treatment of Mycoplasma genitalium infection 3
Limitations and Considerations
- The US Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men 4
- Syphilis diagnosis typically uses sequential testing to detect treponemal and nontreponemal (antiphospholipid) antibodies, and is not typically screened by urine 5
- Antimicrobial resistance limits oral treatment options for gonorrhea and Mycoplasma genitalium, and no cure is available for genital herpes 5