STI Testing

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STI Testing

Sexually transmitted infections (STIs) remain a significant global health concern, with over one million new infections acquired daily, most of which are asymptomatic. Reduced access to prevention, testing and treatment services during the COVID-19 pandemic has contributed to a resurgence of STIs worldwide. This trend underscores the critical need for proactive screening and timely management, even in patients without symptoms.

This page provides guidance on STI testing in asymptomatic patients and outlines recommended approaches for several key infections. To view detailed information on specific STIs, choose from the options down the page.

STI Doctor Brochure

STI Patient Brochure

Testing Guidelines for Asymptomatic Patients
To determine risk, take a sexual history and offer STI screening to all patients who:¹
- Request STI testing
- Are at increased risk of an STI: unprotected sex, new sexual partner(s) or those living or travelling to areas of higher prevalence in Australia or other countries
- Have had a known exposure to any STI or a history of an STI within the past 12 months
- Are the partner of any of the above
^{1. Australian STI Management Guidelines for use in Primary Care. https://sti.guidelines.org.au/ (Accessed 07 March 2024).}
How to Order STI Testing for Asymptomatic Patients
Request Form Instructions:
Complete the Clinical Labs general pathology request form, listing the recommended STIs for asymptomatic screening: Gonorrhoea, chlamydia, syphilis, HIV, Hepatitis B and Hepatitis C.
In the Clinical Notes, add “STI Screen”.
Specimen Details:
Urethral swabs, first-pass urine (FPU) and vaginal/endocervical swabs. Note: Vaginal/endocervical swabs are more sensitive than FPU samples in female patients.
Serology for HIV, syphilis, Hepatitis B and Hepatitis C.
Test Cost:
Bulk-billed, subject to Medicare eligibility criteria.
Opportunistic Testing
Due to the combination of the asymptomatic nature of many common STIs and young adults not presenting to their primary healthcare provider frequently, offering STI screening to patients at risk may need to be opportunistic.
In addition to the previous listing of patients to test, additional opportunities to offer STI screening to patients could include:
- Offering screening to female patients when they attend for their HPV screening from age 25. This is an ideal opportunity as testing for chlamydia and gonorrhoea can be performed on the same ThinPrep vial used to collect the Cervical Screening sample.
- Considering a repeat STI screen for women re-presenting for routine Cervical Screening at 30 years of age.
- Offering screening during contraceptive discussion appointments.
STI Co-Infections

Accurate rates of STI co-infections are often difficult to discern as the infections are notified separately. However, it is well recognised that persons at risk of STI acquisition are also at risk of co-infection with more than one STI. Co-infection of Chlamydia trachomatis in individuals diagnosed with Neisseria gonorrhoeae is well recognised.
In patients presenting with urethritis or other symptoms suspicious of a sexually transmitted infection, it is important to consider co-infections with other STIs. Multisite STI screening for multiple pathogens is recommended for sexually active adults at risk, to identify both symptomatic and asymptomatic infections.