My question relates to the Urine sample i provided. Given two different labs were used by this clinic - one for the Ghon & Chlam & other for MG & Trich, i was asked to pee into two separate sample containers meaning that one was a midstream sample.

I’ve read on this site that Midstream Urine makes no difference to result accuracy for chlamydia and ghon but just wanted to confirm that it’s safe me to assume the same for M. Genitalium and Trich?

(My results were negative).

Thank you

I read your discussion with Dr. Hook several months ago, which also concerned the reliability of urine tests for STDs. It is good to see the evidence that you are conscientious about STD prevention. As Dr. Hook replied then, these are very accurate tests. I'm not sure why the clinic asked for two separate specimens; perhaps official recommendations for the particular tests done at the clinic you attended have different instructions on midstream versus initial urine testing for gonorrhea/chlamydia versus M. genitalium and Trichomonas vaginalis. The gonorrhea/chlamydia tests are pretty much the same world wide, and those results for sure are completely reliable if done sufficiently long after exposure (2-3 days for gonorrhea, probably a week or so for chlamydia). However, there is more variability in testing for trich and M gen, and of course I have no way of knowing what commercial or even home-grown (i.e. locally developed) tests might be in use in Singapore in general or in your clinic.

I will also point out that you had what seems likely to have been a very low risk exposure. And also remember that all STDs are transmitted inefficiently:  most unprotected sexual exposures with infected partners do not result in infection being transmitted. Considering both test performance plus probable low risk of infection, plus you presumably having no symptoms, it is very unlikely you are infected with any of these organisms. However, you might want to discuss the reliability of the M gen and trich tests with your clinic.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

My final question is to check whether Chlamydia,  M. Genitalium and Trich  would be accurately detected 8 days after assuming there had been an exposure (appreciate relative low risks)?.

Thanks Doctor

And yes: all these organisms would test positive 8 days after exposure. You can trust the test results.