testing time line

[kdaily]

Dr. I assist in the STD, Chlamydia, HPV forums... I haven't been on in awhile due to a change in position but have found that my training will be done soon and I'll be able to help again. So in turn I was reviewing older post and came across one regarding the testing time line of STDs. The response to the question for Chlamydia, Gonorrhea and NGU was 3 days for an accurate result. We inform those on the community forum to test after a week for best results.

I guess I'm wondering is 3 days the new testing time line for those three STDs? If so is it really that accurate that soon after? How is it that the test can be so accurate so soon? Can we rely on 3 days for sure? Has this timeline been studied?

I hope my questions aren't too blunt =)

Thanks

[kdaily]

Thank you!
I apologize to stray with new questions; I have so many questions for my own knowledge and to be correct in the std communities. The more correct information I have the more I can help others.
I appreciate the information and will hereby end my own thread. =)

Thank you!

[Edward W Hook, MD]

False negative tests for STDs are most commonly due to either self medication or poorly collected specimens.  Rarely interfering substances (lubricants, etc) can also interfere.  Typically co-existent infections do not interfere with testing.

There really is little meaningful difference in the sensitivity between urine and swab tests for bacterial STDs such as gonorrhea and chlamydia.  There is forthcoming guidance from the CDC which will recommend urine specimens as the preferred tests for GC?CT testing in men and vaginal swab tests as the preferred tests for women.

This discussion started with testing times and now has evolved to touch test types.  Let's not go too far astray.   EWH

[kdaily]

ugg sorry, just one more... between the urine and the swab which of the two has the likely hood of have a false result?

Thanks

[kdaily]

Doctor Hook

I realize its been a month and if need be I'll post a new thread but I had a quick question(s) about false negitives and positives for chlamydia testing.

we've had quit a few questions about this recently. I realize false positives are more prone to occur then false negitives. I guess I am curious what can cause a false negitive; medications? for women current infections like yeast or BV? or even so the treatment of those two? someones own currect health? and what can cause false positive besides testing too soon after a treatment?

I am also aware that the urine testing is more accurate is there a reason since the swab comes directly from the uterus or from the males penis? I know that the urine test will pick up protein is that the reason?

I do apologize but even after assisting an reading post I still find these questions running through my own head as I'm answering I would like to know more about this. I've even thought of taking college courses of sexual health but I know it will be filled with less of what I want to know.

Thanks again!!

[kdaily]

Great thank you for the clarification!

[Edward W Hook, MD]

I don't thnk you need to stick withthe CDC.,  We are comfortable with the 3 day gudiance.  EWH

[kdaily]

WOW, I'm surprised how the time line changes through technology... I was reading older post from 05 and it was recommended to wait 10-14 days and now thanks to the newer more sensitive test it’s down to three days.

I completely understand your post... for my own knowledge and for the other advisers if we were to say 3 days on the community post would that be ok, or should we just stick with 7 due to CDC?

Thank you for the reply!!

[Edward W Hook, MD]

"Assist". I guess so- over 1200 posts.  Welcome back.   Your questions are not too blunt.  They are on target and reflect a subtlety which we may not have explained before.  

There is an important distinction to be made between when tests become positive and when symptoms or infection occur.  In theory, given the biology of bacterial like gonorrhea and chlamydia, tests should be positive even sooner (as soon as the bacteria begin to divide ) than at 3 days but we want to err on the side of conservatism in our advice. Modern nucleic acid amplification tests for gonorrhea and chlamydia are among the most sensitive tests for infection ever described.  On the other hand, symptoms (i.e. burning, discharge, etc) take longer to develop because it takes a while for the body to start "fighting" infection to a degree which then will lead to symptoms. Some people develop symptoms as soon as 3 days but some take longer and some never develop symptoms are all.

Hope this distinction is helpful to you. let me know if I was not clear.  EWH