What STIs are Tested by Urine

Sexually transmitted infections, or STIs, are infections that are primarily spread through sexual contact — and they’ve been on the rise in Canada for over a decade. They were formerly known as sexually transmitted diseases (STDs), but the term STIs have become more commonplace since they account for the fact that infections can be asymptomatic. 

STIs are caused by bacteria, viruses, or parasites. Since many sexually transmitted infections don’t cause symptoms, it’s important to get a routine STI testing panel if you’re sexually active — untreated STIs can lead to serious health problems.

STIs are tested using blood, urine, or a swab of cells or fluid from the infected area. In this blog, we take a closer look at how urine tests for STDs work and which STIs can be detected in urine — along with some helpful tips for giving a urine sample.

What is the Urine Test for STDs?

A urine test for STDs is a non-invasive method used to detect certain bacterial infections, such as chlamydia and gonorrhea, in the body. It involves collecting a urine sample, usually during a clinic or lab visit, which is then tested to identify any presence of bacteria or other pathogens associated with specific STDs. This type of testing is convenient, painless, and effective for detecting particular bacterial infections, making it a common choice for routine STD screenings.

How Do Urine Test For STD Work?

Urine is commonly used to test for bacterial and parasitic infections. Urine tests are quick and simple, and they’re non-invasive — no needles or swabs are necessary.

Your provider will send you to the washroom with a little plastic cup, and you’ll return it with a small urine sample, which will go to the lab. The most common urine test for STIs is a nucleic acid amplification test, or NAAT, which detects the DNA from the bacterium or parasite causing the infection. Urine test results are usually available within a few days.

How Reliable are Urine Tests For STDs?

Urine tests for STI aren’t infallible. As with any medical test, there’s always a potential for a false negative or a false positive due to factors like the sensitivity and specificity of the test. Sensitivity is the probability of a positive laboratory test if the patient has the disease. Specificity is the probability of a laboratory test being negative if the patient does not have the disease in question.

Urine tests for STIs generally have high sensitivity and specificity, making them highly reliable for screening. Still, false results can occur due to contamination in the sample or testing too soon after sex, before the infection is detectable.

Whether you test positive or negative for an STI, your healthcare provider will likely recommend retesting in six to 12 weeks to look for resistant strains of gonorrhea or chlamydia. That way, if treatment didn’t cure the infection — or you took the urine test before the STI was detectable — you can still treat it early enough to avoid complications.

Common STIs Detected Through Urine Testing

Urine tests for STIs are used to detect chlamydia, gonorrhea, and trichomoniasis. They’re not effective for detecting syphilis or viral infections like genital herpes and HIV.

Chlamydia Testing

Chlamydia is a highly contagious bacterial infection and the most commonly reported STI in Canada. Between 2011 and 2019, chlamydia rates increased by 26%.  

The bacterium Chlamydia trachomatis, which causes chlamydia, is easily detected in a urine test for STDs around two weeks after exposure. You can also get tested with a swab sample, such as during a routine pap smear.

Chlamydia is easy to treat with antibiotics — but left untreated, it can cause serious health complications, including infertility, pelvic inflammatory diseases, and reactive arthritis. It can also spread from an infected pregnant person to their infant during birth.

Gonorrhea Testing

Gonorrhea is one of the most commonly reported STIs in Canada, with rates nearly tripling from 2010 to 2019. A highly contagious bacterial infection, gonorrhea is currently treatable with antibiotics, but Canadian health officials warn that this infection is becoming increasingly antibiotic-resistant, which could lead to gonorrhea cases that can’t be cured. Left untreated, it can cause infertility, blood infections, pelvic inflammatory disease (PID), and other health issues.

The bacterium Neisseria gonorrhoeae, responsible for gonorrhea, can take up to two weeks after sex to show up in a urine test for STDs. While urine tests are commonly used to diagnose gonorrhea, a healthcare provider may also perform a swab test. Swabs may be taken from fluid in the vagina, cervix, rectum, urethra, or throat due to the risk of oral gonorrhea cases from oral intercourse. Either way, STD tests by urine are quick, and results usually come back within a few days.

Trichomoniasis Testing

Commonly called “trich,” this less-common STI is caused by a single-celled parasite called Trichomonas vaginalis. It most commonly affects women, who may experience symptoms including foul-smelling vaginal discharge, genital itching or burning, and pain during urination or sex. Men who contract trichomoniasis generally have no symptoms.

Although the incubation period of the Trichomonas vaginalis parasite isn’t known, it’s thought to range from three days to four weeks or longer.

Healthcare providers typically test for trich using a urine sample or a swab of fluids from the vagina or the urethra in the penis. Test results are typically available within a few days. 

Trich is treatable with antibiotics — but all sex partners need to be treated at the same time to prevent reinfection. Untreated trichomoniasis increases the risk of cervical or prostate cancer, and it can lead to premature birth or low birth weight if you’re pregnant.

Preparing for a Urine Test For STD

A urine test for STDs is a simple and effective screening method for certain infections. Here’s a step-by-step guide to help you prepare and understand the process.

Pre-Test Guidelines

• Avoid Certain Activities: Avoid urinating for at least one hour before your urine test for the most accurate results. This makes any potential bacteria or pathogens more concentrated in the urine sample.
• Avoid Products: Don’t use any douches, creams, or other products in the genital area for 24 hours before the test.
• Skip Sexual Activity: It’s generally recommended to avoid sexual intercourse for 24 hours before the test, as recent activity could affect results.
• Moderate Water Intake: Drinking too much water before the test can dilute the sample, affecting accuracy. Ask your healthcare provider for guidance on water intake before the test.

Collecting a “First Catch” Sample

• Use First-Catch Urine: For a urine test for STDs, aim to collect the “first catch” sample, the initial 5 to 20 ml of urine. This first portion often provides the most accurate results for infections.
• Fill According to Instructions: Follow your provider’s instructions on how much urine to collect. Overfilling or diluting the sample could impact the results.

Sample Collection Tips

• Familiarize Yourself with Your Stream: Before the test, observe your urine stream to better position the sterile cup.
• Clean Thoroughly: Use the provided wipes to clean your genital area thoroughly before collecting the sample.
• Encourage Urine Flow: If you’re having difficulty, try turning on the water tap to help you relax and start urinating.

What to Expect During the Test

• Sample Collection: The process usually involves providing a “clean-catch” urine sample. You’ll be given a sterile container and instructions on how to collect the sample mid-stream to reduce contamination.
• Step-by-Step Collection: Wash your hands, use a provided antiseptic wipe to clean the genital area, start urinating, and then collect the mid-stream urine in the container. Avoid touching the inside of the container to keep it sterile.
• Privacy and Assistance: Most facilities offer a private restroom, and instructions are typically available if you have questions.

Post-Test Considerations

• Waiting for Results: Urine test results can take a few days to return, depending on the type of STD being tested. Your healthcare provider will inform you of the expected timeframe.
• Avoid Sexual Activity: Until you get your results, it’s best to avoid sexual activity to prevent potential spread, especially if you suspect an infection.
• Follow-Up with Your Provider: Once you receive your results, your provider will discuss the next steps, including any necessary treatments. If positive, treatment options and partner notification may be recommended to prevent reinfection or spread.

If You Test Positive

• Complete Treatment: Take all prescribed antibiotics as directed, even if symptoms improve.
• Delay Sexual Activity: Avoid sex during treatment and for at least one week after completing your course of antibiotics.

Reportable STIs

• Public Health Reporting: Certain STIs, like chlamydia and gonorrhea, are legally reportable. If you test positive, your healthcare provider is required to inform your local public health department. Reporting is confidential, and your identity is protected.
• Contact Tracing: A public health nurse may contact you to offer support and ask for the names of recent sexual partners. They will anonymously notify your sexual partners, informing them they may have been exposed to an STI.
• Option to Self-Inform: If you prefer to notify partners yourself, the public health nurse can provide guidance on having this conversation.

Follow-Up Testing

• Plan for Re-Testing: Schedule a follow-up test as recommended by your healthcare provider, generally six to 12 weeks after treatment, to ensure the infection is cleared and to monitor your sexual health.

Comparing Urine Testing with Other STI Testing Methods

Advantages and Disadvantages

• Urine Testing:
  • Advantages: Non-invasive, easy to collect, and widely available. Suitable for bacterial infections like chlamydia and gonorrhea.
  • Disadvantages: Limited to certain STIs. It may not detect infections like HIV or herpes, which often require blood or swab testing.
• Blood Tests:
  • Advantages: Can detect viral infections such as HIV, syphilis, and hepatitis. Blood tests offer high accuracy, especially for systemic infections.
  • Disadvantages: More invasive than urine testing. Results may take longer, and some people may find blood draws uncomfortable.
• Swab Tests:
  • Advantages: Effective for site-specific infections, especially in the throat, rectum, or genital areas. Useful for detecting infections with visible symptoms like herpes.
  • Disadvantages: It can be uncomfortable, particularly if symptoms are present. Less convenient for routine screenings as multiple swabs may be needed for comprehensive testing.

Accuracy and Reliability

• Urine Testing: Reliable for detecting certain bacterial STIs in the urinary tract, such as chlamydia and gonorrhea. However, urine tests may miss infections in non-urinary sites.
• Blood Tests: Highly accurate and sensitive for viral infections, making them the gold standard for diagnosing HIV and syphilis. Blood tests also offer early detection of certain infections.
• Swab Tests: Provide high accuracy for localized infections, particularly in symptomatic areas. They’re highly reliable for identifying visible infections like herpes but may not detect asymptomatic infections as effectively.

Scheduling an STI Test

Regular STI testing is an important part of preventive health care for anyone who is sexually active. Yet, a 2018 survey found that 50% of Canadians have never been tested for an STI, citing factors like the fear of a positive result and a lack of a primary care provider. 

If you’re among those Canadians without a primary care provider or unsure where you are going, Maple makes it easy to take control of your sexual health. Maple gives you access to Canadian-licensed doctors and nurse practitioners 24/7/365 within minutes over secure text, audio, or video calls.

At their discretion, primary care providers on Maple can order STI tests,  prescribe treatments, and work with you to determine your risks and create a proactive plan for routine screenings of all kinds. All of your data is in your hands and secure within the app. 

Understanding the importance of STI testing and how urine tests work is important for taking control of your sexual health. Regular testing not only protects your well-being but also helps prevent the spread of infections to others. By staying informed and proactive, you can contribute to a healthier community and ensure peace of mind. Remember, taking the time to get tested is a simple yet powerful way to safeguard your health and foster open, honest communication about sexual wellness.

The information presented here is for educational purposes and is not meant to replace the advice from your medical professional. Virtual care is not meant for medical emergencies. If you are experiencing an emergency like chest pain or difficulties breathing, for example, please call 911 or go to your nearest emergency room.