Understanding your STD Test Results

The Chlamydia, Gonorrhea, Trichomoniasis Test is a nucleic acid amplification test used to detect the presence of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis in a urine sample.

Chlamydia trachomatis is the bacteria that causes chlamydia, Neisseria gonorrhoeae is the bacteria that causes gonorrhea, and Trichomonas vaginalis is the protozoan parasite that causes trichomoniasis. Chlamydia, gonorrhea and trichomoniasis are three common sexually transmitted diseases (STDs). They can be transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected individual. Chlamydia and gonorrhea can also be transmitted from a mother with an untreated infection to her newborn during childbirth.

What are the symptoms of chlamydia, gonorrhea, and trichomoniasis?

Many individuals with chlamydia, gonorrhea, or trichomoniasis do not show any symptoms. For chlamydia, only an estimated 10% of infected males show symptoms and 5–30% of infected females. For gonorrhea, an estimated 85–90% of infected males show symptoms, but only about 20% of infected females. For trichomoniasis, approximately 30% of infected individuals show symptoms.

The symptoms of chlamydia, gonorrhea, and trichomoniasis can be very similar. Females may experience abnormal vaginal discharge, endocervical bleeding, increased urinary frequency, and dysuria. Males can suffer from dysuria, frequent urination, abnormal urethral discharges, and testicular pain and swelling.

Chlamydia and gonorrhea infections of the rectum may lead to rectal pain, discharge, itching, and bleeding. Sexually acquired chlamydial conjunctivitis can also occur in both males and females. Pharyngeal gonorrheal infections are generally asymptomatic but may cause a sore throat.

Untreated chlamydia and gonorrhea in females can lead to pelvic inflammatory disease (PID), and PID-associated infertility, ectopic pregnancy, and chronic pelvic pain. Untreated chlamydia, gonorrhea and trichomoniasis during pregnancy has been associated with preterm delivery, increased miscarriage risk, inflammation of the lining of the uterus, and low birth weight. Chlamydia

and gonorrhea can be passed to newborns during delivery, increasing the risk of chlamydial conjunctivitis and pneumonia, and gonorrhea-associated eye infections and sepsis.

Complications in untreated males can include epididymitis, infertility, and prostatitis. Other potential complications include gonococcal bacteremia, pharyngitis, and reactive arthritis. Chlamydia, gonorrhea, and trichomoniasis also facilitate the transmission of HIV infection.

Who should consider the Chlamydia, Gonorrhea, Trichomoniasis Test?

You should consider getting tested if:

• You are sexually active
• You have had unprotected sex
• You are entering a new relationship
• You are experiencing symptoms of an STD

• You have had a partner with an STD

  If you suspect that you have been exposed to chlamydia or gonorrhea, be aware that there is a “window period” of around two weeks where laboratory assays are unable to detect the bacteria that cause chlamydia and gonorrhea, and a “window period” of around 3–6 weeks where laboratory assays are unable to detect the protozoa that causes trichomoniasis.

  The CDC recommendations for testing include:

• Annual testing for both chlamydia and gonorrhea in all sexually active females < 25 years, and in females > 25 years who have risk factors (e.g., new partner or multiple sexual partners)
• Testing for chlamydia and gonorrhea in all pregnant females
• Annual testing for gonorrhea in all sexually active males < 25 years, and in males > 25 years who have risk factors

• Routine testing for chlamydia in sexually active men who have sex with men, and in clinical settings with a high prevalence of

  chlamydia

• Diagnostic testing for trichomoniasis in females with abnormal vaginal discharge
• Trichomoniasis testing should be considered in high-prevalence settings (e.g., STD clinics) and in individuals with a high risk of infection

• Routine testing for trichomoniasis in HIV-positive females, as successful treatment in these females significantly reduces the genital tract HIV viral load and chance of transmitting HIV

  Understanding your Chlamydia, Gonorrhea, Trichomoniasis Test results

  This section includes general interpretation guidelines for understanding your Chlamydia, Gonorrhea, Trichomoniasis Test

  report. These guidelines may not apply to everyone. Ask your healthcare provider what your results mean for you.

  Result Interpretation

  Negative Nucleic acid (rRNA) from C. trachomatis

  was not detected in the specimen tested. Additional specimens should be collected

  for testing if clinical symptoms strongly suggest a chlamydia infection.

  Positive Nucleic acid (rRNA) from C. trachomatis

  was detected in the specimen tested and strongly supports a chlamydia diagnosis.

  Indeterminate A new specimen should be collected for retesting.

  Result Interpretation

  Negative Nucleic acid (rRNA) from N. gonorrhoeae

  was not detected in the specimen tested. Additional specimens should be collected

  for testing if clinical symptoms strongly suggest a gonorrhea infection.

  Positive Nucleic acid (rRNA) from N. gonorrhoeae

  was detected in the specimen tested and strongly supports a gonorrhea diagnosis.

  Indeterminate A new specimen should be collected for retesting.

  Result Interpretation

  Negative Nucleic acid (rRNA) from T. vaginalis

  was not detected in the specimen tested. Additional specimens should be collected for testing if clinical symptoms strongly suggest a trichomoniasis infection.

  Positive Nucleic acid (rRNA) from T. vaginalis

  was detected in the specimen tested and strongly supports a trichomoniasis diagnosis.

  Indeterminate A new specimen should be collected for retesting.

  What can affect Chlamydia, Gonorrhea, Trichomoniasis Test results?

  A negative result does not exclude the possibility of infection. False negative test results may occur due to improper specimen collection, concurrent antibiotic therapy, presence of inhibitors, or organism levels below the sensitivity of this assay (which is common within two weeks post-exposure).

  False positive results are rare, but may be more frequent in low-prevalence populations. A false positive result may also occur directly after successful antimicrobial therapy, as C. trachomatis, N. gonorrhoeae, and T. vaginalis nucleic acids may persist for three weeks or more.

  Douching and vaginal creams or sprays may also affect test results.

  What are the next steps if I receive a positive test result?

  Contact your healthcare provider as soon as possible. Your healthcare provider may request additional tests and/or begin a course of

  prescribed antibiotics as soon as possible. Abstain from sexual contact until the completion of the antibiotic course or as directed by your healthcare provider. Ensure that any recent sexual partners are aware of your diagnosis so they can also request testing.

  How can I reduce my risk of chlamydia, gonorrhea, and trichomoniasis?

• Abstinence
• Reduce number of sex partners
• Mutual monogamy

• Use condoms correctly and consistently

  Do I need follow-up tests?

  Usually, a test of cure is not routinely required after treatment. However, there are certain situations where a test of cure may be required, including in pre-pubertal children and pregnant women. If a nucleic acid amplification test is used for the test of cure, this should be conducted 2–3 weeks after treatment completion for gonorrhea and 3–4 weeks after treatment completion for chlamydia and trichomoniasis.

  It is often recommended to test for other STDs if you return a positive result for chlamydia, gonorrhea, and/or trichomoniasis. This is particularly important for HIV, as these STDs can increase the risk of getting HIV.

  It is also important to realize that although antibiotic treatment is effective for a current bacterial infection, it does not prevent future infections. This is why it is important for any sexual partners to also get tested (and treated if necessary).

  Talk to your healthcare provider if you have any questions about your test results.

  References

  1. Sexually Transmitted Disease Surveillance, 2018. CDC.

  2. Farley TA, Cohen DA, & Elkins W (2003). Asymptomatic sexually transmitted diseases: the case for screening. Prev Med, 36 (4), 502-509.

  3. Gonorrhea Gonococcal Infection (clap, drip). New York State Department of Health. November 2006.

  4. CDC Fact Sheets for Sexually Transmitted Diseases (STDs). CDC.