General

  • Blood tests alone are inadequate for STI testing
  • A first-void urine sample does not have to be the first urine of the day
  • Never test for HIV without accompanying syphilis serology
  • Never test for Ureaplasma urealyticum and Mycoplasma hominis
Refer to our testing guidelines

Herpes

  • Avoid herpes serology as an STI test
  • Be careful when interpreting results. HSV EIA serology is prone to frequent false positives and negatives
Refer to the herpes treatment guidelines

Chlamydia and gonorrhoea

  • A first-void urine sample (men and women) or high vaginal swab (women) should always be sent for chlamydial and gonococcal testing
  • Men who have sex with men should have a throat and anal swabs for gonococci and chlamydia
Refer to the chlamydia treatment guidelines Refer to the gonorrhoea treatment guidelines

Syphilis

  • A syphilis epidemic is occurring in Victoria
  • Congenital syphilis cases have occurred in Victoria: all antenatal women should be tested for syphilis
  • In interpreting syphilis serology, the TPPA is a reliable indicator of exposure to syphilis
  • Any person with a reactive TPPA and no convincing history of treatment should be treated for syphilis
  • Syphilis should be treated with benzathine penicillin only – not other forms of penicillin
Refer to the syphilis treatment guidelines

Hepatitis B

  • When ordering hepatitis B serology, order HBsAg alone if the patient is jaundiced or acute viral hepatitis is suspected
  • When ordering hepatitis B serology to determine immunity, order anti-HBc and anti-HBs. If anti-HBc is reactive and anti-HBs is negative, then ask the lab to do HBsAg

Hepatitis C

  • Hepatitis C serology is unnecessary, except in injecting drug users and people living with HIV