Testing information for health professionals

Testing for STIs and BBVs for trans, gender diverse and non-binary patients: Information for health professionals

Testing should be based on the patient’s sexual activity. An asymptomatic sexual health test should include screening for bacterial STIs including chlamydia, gonorrhoea and syphilis. Other bacterial STIs are not routinely tested for in asymptomatic individuals. Routine testing for blood-borne viruses should also be offered, including HIV, hepatitis B (and whether patient is already immune to hepatitis B). Hepatitis C should also be considered, depending on the risks.

When recommending future testing, if the individual has any sexual activity with more than 10 different people in a six-month period they should be testing approximately every 3 months. If they have any sexual activity with 2-10 people in a six-month period, they should be testing approximately every 3 to 6 months. If there has only been a change in one sexual partner in the past 12 months, they should only test once every 12 months.

There is useful information on these websites:

• Australian STI management guidelines
• Silver book – STI/BBV management guidelines
• TransHub – Information for clinicians

The TransHub website includes information re: Getting Started, Creating Welcoming Environments, Hormones, Surgical Affirmation, Mental Health, Sexual Health, Fertility and Reproductive Health
and Sexual Assault.

The information on this page is also available as an appendix in the pdf letter template, which you can download and print.

Site Specimen
Pharyngeal swab (dry swab PCR)

When to test

When the patient engages in any of the following:

• Oral sex of any kind
• Deep kissing
• Cunnilingus
• Anilingus (rimming)

STI testing to order

• Chlamydia
• Gonorrhoea

Site Specimen
First Void Urine (PCR)

When to test

When the patient with a penis engages in any of the following:

• Oral sex of any kind
• Insertive vaginal/fronthole sex
• Insertive anal sex

When the patient with a vagina/fronthole engages in:

• Oral sex of any kind
• Receptive vaginal/fronthole sex

STI testing to order

• Chlamydia
• Gonorrhoea

Site Specimen
Self-Collected Lower Vaginal Swab (PCR)

When to test

When the patient with a vagina/fronthole engages in any of the following:

• Oral sex of any kind
• Receptive vaginal/fronthole sex

Please note if the patient states having vaginal/fronthole discomfort then utilise First Void Urine instead

STI testing to order

• Chlamydia
• Gonorrhoea

Site Specimen
Rectal Swab

When to test

When the patient engages in any of the following:

• Anilingus
• Receptive anal sex

STI testing to order

• Chlamydia
• Gonorrhoea

Site Specimen
Serology

When to test

When the patient with a penis engages in any of the following:

• Oral sex of any kind
• Deep kissing
• Cunnilingus
• Anilingus
• Insertive vaginal/fronthole sex
• Insertive anal sex
• Receptive anal sex

When the patient with a vagina/fronthole engages in any of the following:

• Oral sex of any kind
• Deep kissing
• Cunnilingus
• Anilingus
• Receptive vaginal/fronthole sex

STI/BBV testing to order

• HIV (only if previously negative)
• Syphilis
• Hepatitis A IgG EIA (if not previously immune)
• Hepatitis B surface antigen + antibody (if not previously immune)
• Hepatitis C antibody (RNA only if previously had Hepatitis C)