STI Testing Tool

Who? Why? Which? How?

is the patient? would you do an STI test? STI WHAT specimen do you need? WHAT test do you order?

First pass urine OR

Chlamydia Self-collected vaginal swab OR NAAT
A sexually active young person Endocervical swab
This population is at higher risk for Chlamydia
under 29 years
HBV Consider vaccination for HBV
& HPV

First pass urine OR

Chlamydia
Self-collected vaginal swab OR NAAT
This population is at higher risk for Chlamydia Gonorrhoea Endocervical swab
A sexually active Aboriginal
* Can also be conducted as part of the Aboriginal health check -
young person under 29 years Medicare item 715 Blood
HBV Consider vaccination for HBV HBcAb
& HPV

First pass urine OR

The patient has requested it, so may be at risk. Chlamydia Self-collected vaginal swab OR NAAT
An (asymptomatic) person Endocervical swab
Ideally, take a sexual history to ascertain:
of any age requesting
a) if they fall into one of the groups below HIV Blood HIV Ab
a STI checkup
b) help you decide on sites for specimen collection Syphilis Syphilis EIA
HBV Consider vaccination for HBV HBcAb

Chlamydia First pass urine & anal swab NAAT

Throat swab Gonorrhoea culture
Gonorrhoea
A man who has sex with men This population group is at higher risk for Chlamydia, Anal swab NAAT
(MSM) Gonorrhoea, Syphilis, HIV, HAV, HBV HIV HIV Ab
Blood
Syphilis Syphilis EIA
HAV Vaccinate for HAV & HBV
HAV Ab (total)
HBV HBcAb

First pass urine OR

Chlamydia Self-collected vaginal swab OR NAAT
This population group is at higher risk for Chlamydia, Gonorrhoea Endocervical swab
A sex worker Gonorrhoea, Syphilis, HIV, HBV
HIV Blood HIV Ab
See above for MSM sex workers
Syphilis Syphilis EIA
HBV Vaccinate for HBV HBcAb

Chlamydia First pass urine OR

Gonorrhoea Self-collected vaginal swab OR NAAT

Produced March 2012

This population group is at higher risk for Chlamydia, Endocervical swab
A person who injects drugs Gonorrhoea, Syphilis, HIV, HBV and HCV*
* HCV is not an STI but is included due to risks associated with HIV HIV Ab
Blood
injecting drugs Syphilis Syphilis EIA
HBV Vaccinate for HBV
HBcAb
HCV HCVAb
HAV = Hepatitis A HPV = Human Papilloma Virus NAAT= N
 ucleic Acid Amplification Information on vaccination www.immunise.health.gov.au
HBV = Hepatitis B Test (eg: PCR) Information on HIV Pre & post-test discussion www.ashm.org.au/uploads/HIV_viral_hep_Chapter_9.pdf
HCV = Hepatitis C
Getting started with an STI discussion
Bringing the subject up opportunistically Other risk behaviours
We are offering Chlamydia testing to all sexually active people under the age of 25, Id now like to ask about some other activities that could increase a persons
would you like to have a test while youre here or find out more about Chlamydia? risk of certain infections, is that OK?
 ave you had any tattoos? If yes, was that here in Australia or
H
overseas?
Using a hook

Have you ever injected drugs?
Have you ever shared needles or injecting equipment?
Have you heard about HBV or HPV vaccination? They protect against infections that can Have you ever been in gaol?
be sexually transmitted, perhaps we could discuss these while youre here?
Consent
As part of a reproductive health consultation I suggest that we test for... eg: Chlamydia
This will involve a urine test. Can you tell me what you understand
Since youre here today for a pap smear/to discuss about contraception could we also talk about some other about Chlamydia?
aspects of sexual health, such as an STI check up?  the result is positive, we can also talk about recent partners youve
If
had being tested as well.

Because the patient requests a checkup for STIs Contact tracing

Contact tracing aims to reduce the transmission of infections through early
Id like to ask you some questions about your sexual activity so that we can decide detection and treatment of STIs. It is the diagnosing clinicans responsibility
what tests to do, is that OK?(See Brief Sexual History ) to initiate a discussion about contact tracing.
From what you have told me today there are a few people who need to be
informed. Would you like some tips about how to do this?
Brief Sexual History

For more copies of this STI Testing Tool: www.stipu.nsw.gov.au

Explain different methods and offer choice: Different methods might be
needed for each partner. (in person, phone, SMS, email or letter)
Id like to ask you some questions about your sexual activity so we can decide what tests to do, is that OK? Theses sites can support your patients to tell their partners:
Are you currently in a relationship? www.letthemknow.org.au www.thedramadownunder.info (MSM)
In the last 3 months, how many sexual partners have you had? How many partners have you had www.bettertoknow.org.au (Aboriginal People)
in the past 12 months?
Were these casual or regular partners? Contact Tracing resources
Were your sexual partners male, female or both? Tool www.stipu.nsw.gov.au/pdf/May_2011_Contact_tracing_ final_version.pdf

When was the last time you had vaginal sex/oral sex/anal sex without a condom? Manual ctm.ashm.org.au/
Letters www.gpnsw.com.au/programs/sexually-transmitted-infections-sti/contact-tracing
In the past year were you ever paid for sex?
Have you previously been diagnosed with an STI?
Support
Is there anything else that is concerning you?
General Practitioners, Health Care Workers and patients can ask for support
from their local Sexual Health Clinic
NSW
SEXUAL www.health.nsw.gov.au/PublicHealth/sexualhealth/sexual_phus.asp OR call
HEALTH
INFOLINE NSW Sexual Health Infoline 1800 451 624
1800 451 624
Red Book www.racgp.org.au/Content/NavigationMenu/ClinicalResources/
Mon - Fri

Australasian Chapter of Sexual Health Medicine

9am - 5:30pm RACGPGuidelines/TheRedBook/redbook_7th_edition_May_2009.pdf

Ref: Clinical Guidelines for the management of STIs among Priority populations