[Question #3639] STI Testing
87 months ago
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Hello,
I am wondering -- is the urine test for gonnorhea and chlamydia (NAA test) reliable for women? Or would it be necessary to have a vaginal swab done to be able to completely rule out infection?
Thanks
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H. Hunter Handsfield, MD
87 months ago
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Welcome to the forum. Thanks for a succinct, straightforward question.
Urine testing of women for gonorrhea and chlamydia is good but not perfect. It picks up about 90% of infections compared to testing a vaginal swab, the specimen of choice. STD and public health experts recommend urine testing in women when large numbers are being tested (e.g. in a school, job placement center, etc -- where vaginal swabs are inconvenient). But in doctors' offices and clinics, or when there is a high suspicion the woman is infected, a vaginal swab is preferred and recommended.
Let me know if anything isn't clear. Best wishes and stay safe--
HHH, MD
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87 months ago
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I only ask because a few months ago, I had a very brief unprotected one time encounter with someone other than my usual partner. Afterwards, I went and was tested for several STD's and everything came back clean, so I felt comfortable resuming being intimate with my partner. The gonorrhea and chlamydia tests that I had done were urine tests. As a matter of fact I had the urine tests repeated to try to ensure that I was in the clear; each time they were negative. I was set to move on from this until I read about the vaginal swab. Now I wonder if I need to go for that, too.
My real concern here would be infecting my current partner. He has not expressed to me that he is having any kind of symptoms. I have tried to be careful.
Thank you for the information
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H. Hunter Handsfield, MD
87 months ago
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Having two negative urine tests increased the test reliability to the same level as a single test on a vaginal swab specimen. Further, lack of symptoms in both you and your current partner is evidence you aren't infected -- not proof in itself, but it further lowers the already low chance you have chlamydia or gonorrhea. My advice is to have no more testing and continue your normal sexual practices with your current partner.
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87 months ago
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I tried to keep my initial question as simple as possible but I feel like I should explain a little bit more, so I am sorry.
I would not say that I have felt particularly symptomatic... however, over the last few weeks I have noticed I’ve had the urge to need to urinate more often. I haven’t had pain, or burning, just what seems to be frequency and maybe a little pressure down in that area. Last week I saw my doctor about it and my urine showed traces of blood & WBCs and she suspected a UTI, so she put me on macrobid & sent my urine for culture. I did feel as though the antibiotic helped, and I’m not sure if I feel totally back to ‘normal’ yet, but I don’t seem to have to go to the bathroom as frequently. Just yesterday I heard back that my urine culture was negative for UTI, so I’m a little confused as to what may be going on. I will say that I have a history of kidney stones, and although I haven’t had pain associated with them recently (I don’t believe any are actively moving), I do know that I have several stones currently in both kidneys. Could this be the reason for the blood/WBC’s in the urine, or do the presence of those two things definitely indicate a problem?
Based on hearing this, would you change your previous recommendation about not doing further testing for gonorrhea & chlamydia? As I stated earlier - I went for 2 chlamydia urine tests and probably about 3 or 4 urine gonnorhea tests (because that was my bigger concern) and all have been negative. This testing is costly and mentally exhausting and I would love nothing more than to feel comfortable enough that I don’t need to continue with it. At this point, I’m trying to decipher if there is an actual issue or if I am just way too in my own head.
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H. Hunter Handsfield, MD
87 months ago
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Thanks for the additional information, but it doesn't change my opinion or advice. Chlamydia and gonorrhea can mimic UTI symptoms, but in that case, urine testing definitely would have been positive. You're a better judge than I can be about whether you are "just way too in my own head", but I'm confident you don't have either of these STDs.---