STD Testing

  • Fast & Discreet.
  • Results by SMS or your preferred method.
  • See the doctor once & get your tests covered by medicare.
  • Other appropriate tests can be arranged at the same time.
  • Scripts usually by phone at no additional cost.
  • See the STD testing FAQs for details.

No Need to be Embarrassed.

STD Testing Brisbane

About STD testing

People of all ages ask for STD testing at The Medical Centre – and for good reason given that the conditions are best diagnosed early, easily treated, and the samples usually only require urine and blood testing. Most people who carry an STD have no symptoms. For example, 90% of people who carry chlamydia have no symptoms.

Those with symptoms will probably think of making an STD Clinic appointment whereas STD testing is most often requested in people who are concerned about potential exposure through a current or previous partner. There is no need to be embarrassed about asking for STD testing. Seeing a GP for STD testing ensures access to the most appropriate and comprehensive tests & discussion of any health concerns.

The tests are medicare rebated. For simple STD testing, an examination (inspection) is not required & you collect the urine sample. The tests themselves are carried out in government-approved laboratories and therefore quality assured.

Should I get an STD Test?

Most people know if they are at risk of an STD and are right to ask for a test before symptoms have developed. Younger people may feel more embarrassed of requesting an STD Test – just remember it’s a daily occurrence for the GP, & involves simply a free urine and blood test.

The bacterial STDs are usually easily cured, Chlamydia with a one-off dose of antibiotics.

Recent advances in the treatment of HIV, Hepatitis B and C make an early diagnosis a positive outcome. New Antivirals are coming on stream all the time and early treatment has a very good chance of preventing long term complications such as Cirrhosis.

Which STD tests are usually performed?

The STD tests in standard screening may include:

bacterial sexually transmitted diseases

Bacteria from a Urine Test: Chlamydia, Gonorrhoea, Trichomoniasis

Note that many pathology laboratories will check for Gonorrhoea automatically when Chlamydia urine testing is requested. There was some controversy regarding possible “False positives” in 2015. A prominent pathology provider  pointed out that positive results are confirmed with a further analysis on the same sample (a different test) and therefore a false positive result “would be rare.”

Increasingly Mycoplasma Genitalium is also tested for.

Viruses from a Blood Test HIV, Hepatitis B, Hepatitis C. Hepatitis B & C are more likely to be caught through blood to blood contact (contaminated needles for example, or from overseas) than sexually.

Syphilis, a bacteria, is also tested from a blood sample.

Are there tests for genital warts or genital Herpes?

There is no practical STD testing for genital warts –  you either have them or you don’t. Rarely, the diagnosis be uncertain, however, and biopsy may be performed.

There is also no practical screening test for genital herpes (when there are no lesions) because 80% of people test positive on a blood test to past exposure to the HPV virus. However,  active lesions are easily tested with a swab for  viral DNA. There are two types of HSV: Type 1 and Type 2. A swab will distinguish the two types. Type 1 Herpes virus is the classical cause of cold sores (around or inside the mouth). Type 2 HSV is the classical “genital” type. There is a lot of overlap, and both types can cause mouth or genital herpes.

There are situations when a blood test for Herpes may be useful. Let’s take a common scenario of somebody with recurrent genital herpes who is concerned about passing it on to their partner. In this example, the person with recurrent genital herpes has a blood test and is positive for Type 2 antibody. Their partner is offered a blood test. The partner who tests negative for Type 2 HSV would then be susceptible to infection. Based on these results, the person with recurrent herpes may wish to take daily anti-viral medication and thereby reduce the risk of transmission to the partner.

How are the samples collected?

You will be provided with two forms for standard STD testing: requests for a blood test and a urine test.

The urine test is collected differently from a “mid stream urine” and it’s important that the sample is correctly taken. The urine sample is a “first pass” sample.  It’s not the urine from the bladder that matters. The idea is for the urine to flush through any bugs hiding in the urethra (the end of the urinary tract). Therefore, the urine is collected at least 2 hours after you last went – or the first sample of the day. Only the first portion of urine is collected. Fill the container until it’s at least a third full. Put the sample in the fridge if there is a delay between collecting the sample and dropping it off at your local pathology provider. You may also drop the sample off at the clinic.

Women also have the choice of a self taken vaginal swab or a first pass urine sample. The self taken dry swab is simply inserted around 2-3 inches into the vagina and gently rotated for around half a minute. The clinic will provide you with the swab and form and drop the sample off at your chosen pathology provider. The swab has a higher pick-up rate for chlamydia and is now the preferred method for chlamydia screening in women.

What type of STD blood test does the laboratory perform?

HIV tests performed in Australian accredited laboratories are “4th generation” and these HIV tests that are positive between 2 and 6 weeks after exposure.

Hepatitis B: The Hepatitis B surface antigen (HepBsAg) is a screening test for previous exposure to hepatitis B infection. For those at high risk for hepatitis B, additional tests may be requested: anti hepatitis B core antibody (anti-HBc) & anti hepatitis B surface antibody (anti-HBs). Around 1% of Australians are Hepatitis B positive – of whom around half are not aware they have the diagnosis. Hepatitis B is more likely to be caught from previous “blood to blood contact” such as contaminated needles than sexually.

Hepatitis C:  The Hepatitis C screening test is Hepatitis C Viral antibody (HCV antibody). Just under 1% of Australians are hepatitis C positive – of whom around 15% are not aware they have the diagnosis. Hepatitis C is more likely to be caught from previous “blood to blood contact” such as contaminated needles than sexually.

Syphilis testing: Antibody to the bacteria (Treponema) will detect past infection. Note that (only) 75% of people with a primary ulcer caused by Syphilis (primary chancre) will have a positive blood test – so anyone with a possible Syphilis ulcer will need a simple swab taken from the ulcer base.

What’s the best test for early HIV infection?

Antibodies to HIV take 6 to 12 weeks after exposure to become positive – so you have to wait at least 6 weeks for the 3rd generation HIV test.

The fourth generation test combines an Antibody test with the p24 Antigen. The 4th generation test is positive within 1 month of exposure (often from 2 to 3 weeks) and is the most commonly performed test in Australia.

A positive HIV test will only be known for sure after a second confirmatory test. The first test is a screen and may be falsely positive. The second test will distinguish HIV 1 from HIV 2.

What’s the best test for Syphilis?

The pathology provider will perform various tests “behind the scenes” depending on the initial blood result. These tests include Syphilis antibody, RPR and TPPA. The possible outcomes are negative, active syphilis infection or latent syphilis. Note that a negative blood test does not rule out syphilis in the early days and may need to repeated.

Men who have Sex with Men

Standard MSM STD guidelines recommend blood testing for  Syphilis, Hepatitis B, Hepatitis C & HIV. Swabs should also be collected for Gonococcus & Syphilis. There is now good evidence to support self-taken samples¹ and the doctor will discuss this option with you. Self collection samples are taken in the privacy of your own home and then taken to your pathology provider of choice.

How common are the different STDs in Australia?

The incidence of Chlamydia has doubled between 2001 and 2013. The rate in males aged 15 to 24 has increased from 2.7% in 2001 to around 7% in 2013 – so that carriage of chlamydia is now more common in males than females.

Mycoplasma: An emerging cause of STD

Mycoplasma Genitalium is a bacteria that is increasingly diagnosed as a cause of STD in Australia. Symptoms of Mycoplasma may be very similar to that of Chlamydia – causing symptoms such as a discharge from the urinary tract in men or women, or proctitis. There is recent evidence of a link between mycoplasma and pelvic inflammatory disease (PID).

The diagnosis has up until now required cultures on a swab or urine sample. The samples need to to be collected separately. There are now DNA tests which are the equivalent tests performed for chlamydia and gonococcus.

Treatment is with most often treated with the same antibiotic used to treat chlamydia – however, the bacteria is often resistant to Azithromycin and moxifloxacin may be required.

In summary, think of Mycoplasma when STD symptoms such as a urethral discharge or PID have not resolved. In addition to this, Mycoplasma will increasingly be tested for routinely.

How common are the different STDs in Australia ?
STD Australia – most recent dataNew Cases: 2012New Cases: 2011
Chlamydia82,70779,833
Gonorrhoea13,64911,845
Syphilis15341233
HIV1253 (25,708 total cases)1031
Hepatitis B6702 (207,000 total cases)7,000 (approx)
Hepatitis C10,114 (230,000 total cases)10,261

FAQs

How and when do I get my results?

Confidentiality is critical to our service.

We understand that you will want to know the results “either way” and won’t be wanting to make an appointment for negative results.

Negative results are sent to you by a discrete Text, Email, or phone – it’s your choice.

For a positive result the doctor will either ring your or need to see you.

Results take up to 2 working days.

What do I let reception know when I ring them?

The receptionists will usually ask the reason for your attendance at the practice. The reason for this is that people attend the practice for all sorts of reasons and this has implications in terms of urgency, appointment length and who you see.

However, for STD Testing you simply need to ask for “A short appointment with Dr Beatty” – when asked why, you may simply state “to request a blood test” or you may say you’d prefer not not to say.

What length of appointment do I need?

A short appointment is all that’s needed for straightforward STD testing in someone without symptoms. When you have symptoms of an STD then please refer to our STD Clinic page for details.

Where are the blood tests done?

The tests are done at your chosen pathology provider. There’s a large range of collection centres in Brisbane. The best known are S&N and QML Pathology. There is also a pathology provider adjacent to the practice.

Who gives my results?

The default is that the doctor will give your results unless you agree otherwise.

References
1: The “3 in 1” Study: Pooling Self-Taken Pharyngeal, Urethral, and Rectal Samples into a Single Sample for Analysis for Detection of Neisseria gonorrhoeae and Chlamydia trachomatis in Men Who Have Sex with Men. J Clin Microbiol. 2016 Mar;54(3):650-6
WRITTEN BY: Dr Richard Beatty
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