STDs Expert Forum
Self Test for Some STDs
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Self Test for Some STDs

I was wondering if I could get your views on men self-screening for gonorrhea and Chlamydia using urinary tract infection strips for women.  A lot of guys at my college are doing this.  They hold their urine for a couple of hours, and then pee a tiny bit into a cup.  This is a little different from the instructions, which say to urinate for a few seconds first.  The idea is to catch any white blood cells in the penis.  The guy will mix it up a little, and then dip the test strip in.  If the test strip shows that there are white blood cells in his urine, he will go get tested at the school’s infirmary.  (A couple of my frat brothers tested positive with the test strips, but the infirmary said they didn’t have anything.)  If it shows nothing, they decide they don’t need to get tested.

I’m sure you don’t approve of this practice.  No doctor would.  But is this at least plausible?  Some of my frat brothers who are pre-med did some research, and they say that this should pick up gonorrhea, but they found some studies that say it might miss Chlamydia.  They say that if you have gonorrhea there will be so many white blood cells in your urethra that there’s no way the test will be negative.  But, like one of my friends who has had gonorrhea pointed out, if you have gonorrhea you will know it unless you are in hard core denial, because there’s a ton of mucous coming out of your penis.

I’m sure everyone will be eager to hear your thoughts.   I should mention that even though STD tests are free at my school, let’s face it guys want to avoid the swab in the penis if possible.  So they think that this test lets them know if they absolutely have to go get tested.
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You are correct this is not a practice we would recommend however, urine can be tested to indicate the presence of STDs in several ways.  As your friends are doing, the proper test of urine for STDs is to not urinate for several hours and then to collect the urine just as a person begins to urinate.  Urine collected in this way can be tested in several ways:
1.  I can be tested for the presence of white blood cells using a dip stick.  White blood cells detected in this way are suggestive of urethral (penile) inflammation which could be due to gonorrhea, chlamydia or NGU.  this sort of test is positive in about half to 2/3 or men with urethral STDs.
2.  Urine collected as described can be sent to the lab for specific testing for gonorrhea or chlamydia.  Such testing is ALMOST as sensitive as a swab specimen taken from the penis but not quite as good.  

Hope these comments are helpful.  I suspect that you or at least some of your friends qualify for what we call periodic (about once a year) "screening" for STDs.  By screening, I mean testing in the absence of symptoms because you have had multiple partners over a period of less than a year.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).

Hope this is helpful. EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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