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SEXUALLY TRANSMITTED INFECTIONS

This section features an overview of the relatively new, noninvasive tests for the diagnosis of Sexually Transmitted Infections (STIs).

These tests diagnose Chlamydia (Chlamydia trachomatis) and Gonorrhea (Neisseria gonorrhoeae) by testing a sample of your urine.

Because they are noninvasive they are particularly suited if you are a teenager. Teenagers usually feel uncomfortable with the other methods of detecting STIs, which require the doctor to perform a pelvic exam, or to take a sample from inside the penis.

INTRODUCTION

Sexually active teenagers have higher rates of most Sexually Transmitted Diseases (STDs) than any other segment of the population.
Approximately 25% of all new cases of STDs are contracted by sexually active teenagers.
Chlamydia and Gonorrhea are bacterial STDs, meaning the organisms that cause them are bacteria. There are other STDs, like Syphilis, Herpes, HIV, HPV/genital warts, but the following discussion applies only to Chlamydia and Gonorrhea.
If the bacterial STDs are left untreated, not only can they be transmitted to a sexual partner, but they can also cause a lot of serious problems. For example, they can lead to Pelvic Inflammatory Disease, infertility, ectopic pregnancy, chronic pelvic pain and strictures of the penis, just to name a few.

THE TESTS (NUCLEIC  ACID  AMPLIFICATION  TESTS)

Several test are now commercially available for detecting Chlamydia and Gonorrhea by testing a urine sample.
This is the way these tests work: a urine sample is collected, the DNA or RNA of the bacteria is multiplied about 1 billion times and the test result is available within 2-3 hours.
The 4 tests currently available are: polymerase chain reaction (PCR), ligase chain reaction (LCR), strand displacement amplification (SDA), and transcription-mediated amplification (TMA).
The first 3 types of tests amplify the bacterial  DNA, and the fourth one amplifies the bacterial RNA.
The main advantages of these tests are the fact that they allow detection of STDs in a noninvasive manner and the ability to detect many more Chlamydia and Gonorrhea infections.
The main disadvantages are the relatively high cost, the limited availability and the fact that the results may not be used in a court of law in rape cases.
Please note that, even though with these urine-based detection tests, it is no longer necessary to perform a pelvic exam, this exam may be warranted because of clinical symptoms or the need to perform a Pap test.
Finally, if you think you might be interested in these type of tests, please make sure to discuss the information with your doctor.



More on Chlamydia tests, here .






References
1. Contemporary OB/GYN. March 2001,vol.46, no.3, pp 103-121




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