Rectal and Oral Gonorrhea / Chlamydia#

Site-specific swabs are recommended when you've had unprotected exposure at the relevant site and have at least one of the following:

• You identify as gay, bisexual, or a man who has sex with men.
• You are a trans woman who has sex with men.
• You engage in sex work or have had sexual contact with someone who does.
• You are a known contact of someone diagnosed with chlamydia or gonorrhea.
• You have signs or symptoms of rectal infection after receptive anal sex, such as rectal pain, discharge, urgency, bleeding, or new unexplained rectal symptoms.
• You have signs or symptoms of throat infection after performing oral sex, such as sore throat or swollen glands.

These are guideline indications. If you're outside these groups and want site-specific testing for peace of mind after an exposure, you can still request the kit and the clinician will review. Trans, non-binary, and gender-diverse patients are welcome - the same anatomy-based logic applies regardless of gender identity.

Chlamydia and gonorrhea NAAT (nucleic acid amplification testing) is most reliable once enough time has passed after exposure, commonly around 1-2 weeks. Testing too early can produce a false-negative result because the bacteria may not yet be present at detectable levels.

• Symptomatic patients can test right away - the swab is still useful to confirm the diagnosis and guide treatment, and treatment may be started empirically while waiting for the result depending on the clinical situation.
• Asymptomatic exposures are best tested at 1-2 weeks post-exposure for the most reliable result.
• Tested very early within a few days and got a negative result? That result is somewhat reassuring, but it does not fully rule out an early infection. Your clinician may recommend repeating the test at the 2-week mark if the exposure is concerning.

Each TeleTest shipment includes the supplies needed to collect the requested rectal and/or throat samples, including transport tubes, swabs, site labels, and a printed information sheet with visual diagrams.

For rectal and throat collection, use the woven swab only. Do not use a flocked swab for rectal or throat testing, because the specimen may be cancelled by the lab.

One kit shipment can cover both sites. If you've had both anal and oral exposure, collect both swabs and submit them together at the lab. If you only need one site tested, collect and submit only that site.

Make sure the right site label goes on the right tube - mislabelled samples are rejected by the lab.

Site-specific swabs are not automatically part of TeleTest's quarterly PrEP follow-up. Quarterly PrEP visits typically include HIV/syphilis bloodwork and urine PCR for chlamydia and gonorrhea, but rectal and throat swabs are an add-on that you can request when relevant.

If you've had anal or oral exposure since your last test, mention it in your PrEP intake so the clinician can add site-specific swabs to the requisition. See PrEP for the full PrEP monitoring schedule.

The mailed TeleTest swab kit is currently available to Ontario patients only. TeleTest does not currently ship swab kits to BC or other provinces.

If you're in BC, you may still be able to access site-specific testing through TeleTest by bringing your own swab if the correct swab type and public-health lab pathway are available. The swab type and transport media must match what the provincial laboratory accepts for rectal or pharyngeal chlamydia/gonorrhea NAAT testing. These supplies may be available through a hospital outpatient lab, walk-in clinic, sexual-health clinic, or provincial lab pathway. Our clinician can then review whether the swab order can be added to your TeleTest requisition.

If you're in another province, contact us through the contact form and we'll let you know what's possible based on your provincial lab routing.

See the STI Testing Overview for more on the bring-your-own-swab pathway and provincial lab options.

• Negative - no chlamydia or gonorrhea was detected at the tested site. If testing was done at least 1-2 weeks after exposure, a negative result is more reassuring. Very early testing can miss infection.
• Positive - chlamydia or gonorrhea was detected at the tested site. See the next accordion for next steps.
• Indeterminate / equivocal - the lab could not produce a clear result. This is uncommon and may be due to insufficient sample material, contamination, or technical factors. Your clinician will message you with next steps - usually a repeat collection.
• Sample rejected - the lab couldn't process the swab. Common reasons include unlabelled or mislabelled samples, wrong swab type, visible stool contamination, spilled transport media, expired collection kit, or requisition/specimen-source issues. You'll need a new kit; see the troubleshooting section below.

Results are uploaded to your TeleTest portal when the lab releases them.

A positive result for chlamydia or gonorrhea at a rectal or throat site is treatable. Next steps depend on which infection is detected, the site, your allergy history, pregnancy status, and whether other STIs have also been ruled out.

• Chlamydia is usually treated with oral antibiotics.
• Gonorrhea usually requires an injectable cephalosporin antibiotic (third-generation) given as a single injection. Oral-only treatment is not usually the standard first-line approach.
• A follow-up test to confirm the infection has cleared is recommended after gonorrhea treatment, at every site that tested positive (throat, rectum, urethra, or cervix). The repeat test is usually done 3-4 weeks after you finish treatment, using the same swab method you had originally. Some clinics may use a different lab method (called a culture, which grows the bacteria) if it's available locally.
• A follow-up test for chlamydia is not routinely needed, except in specific situations: if you are pregnant, your symptoms haven't cleared, you missed doses or aren't sure you finished the antibiotic, a different antibiotic was used than the standard one, or your clinician mentions a less common type of chlamydia (called LGV) that needs extra follow-up.
• Repeat screening is recommended after treatment because reinfection is common. PHO guidance recommends repeat screening 3 months after chlamydia and 6 months after gonorrhea.

See the STI Testing Overview for the full treatment and follow-up details.

No - TeleTest does not contact partners directly. Partner notification is your responsibility, but it matters: untreated partners are the main cause of reinfection.

• Tell partners from the relevant exposure window so they can get tested and treated.
• TeleTest does not offer expedited partner therapy (EPT). Your partner cannot pick up a prescription written for you. They need to complete their own intake and consultation so the clinician can review their allergies, drug interactions, and pregnancy status before prescribing.
• Public health may follow up if the lab reports certain notifiable STIs (such as gonorrhea) to the provincial public-health authority. They will contact you confidentially first.
• Anonymous notification options like online "tell your partner" services can help if direct contact feels difficult.

The recommended retesting interval depends on your level of ongoing exposure:

• Higher-risk patients (multiple partners, recent STI, sex work, ongoing condomless exposure) - every 3-6 months.
• Average-risk patients with periodic exposures - annually, or after any new exposure.
• After a positive result - repeat screening is recommended after treatment because reinfection is common. PHO guidance recommends repeat screening 3 months after chlamydia and 6 months after gonorrhea.
• PrEP users - site-specific swabs are not part of the routine quarterly PrEP follow-up but can be added when there has been a relevant exposure since your last test.

If you develop new symptoms at any time between scheduled tests, test right away regardless of the schedule.

You can take the unopened kit to any walk-in clinic and ask the clinician to collect the swab for you. Bring the requisition from your TeleTest portal so the clinic knows the swab is part of your TeleTest order. The lab still processes it through the same accredited equipment.

This is a particularly good option if past sexual experiences, vaginismus, or anxiety make self-collection difficult.

Site-specific chlamydia and gonorrhea testing is covered by your provincial health plan when collected at an in-person clinic - a walk-in clinic, sexual-health clinic, family doctor, or public-health unit. If cost is your main concern, going in person to a clinic that offers site-specific swabs is the most affordable route.

TeleTest's mailed swab kit is a paid service for patients who'd rather self-collect at home and skip the in-person visit. The kit, the consultation that authorizes it, and shipping are paid out-of-pocket. Patients on an active STI subscription can add the kit at reduced shipping cost.

Lab processing at the provincial public-health laboratory is covered by your provincial health plan in either pathway if you're an eligible resident with provincial health coverage; out-of-province or uninsured patients may have additional fees.

Check your TeleTest portal for current kit and subscription pricing.

Site-specific swabs are safe during pregnancy. Use gentle technique for rectal collection (the same care as for any patient with hemorrhoids or recent rectal symptoms). Throat collection is unchanged.

If you test positive during pregnancy, treatment matters - untreated chlamydia or gonorrhea can cause complications for you and the baby. The clinician will choose a pregnancy-safe antibiotic.

No fasting is required, but avoiding food, drink, mouthwash, and brushing your teeth for 30 minutes before collection is recommended. This reduces the risk of gag-reflex problems during the swab and minimizes the chance of saliva or food residue affecting the sample.

Specimens collected in the correct transport media are stable at 2°C-30°C for an extended period. Refrigeration is not required.

We recommend dropping the sample at the lab as soon as possible after collection for fastest results, but a delay of a few days should not make the specimen invalid if it was collected into the correct, unexpired transport media and stored properly.

A delay of a few days should not make the specimen invalid if it was collected into the correct, unexpired transport media and stored at 2°C-30°C. However, labs may still reject or cancel specimens for other acceptance reasons.

Common reasons a lab may reject or cancel a sample include:

• Unlabelled or mislabelled swab.
• Missing name, date of birth, or specimen site.
• Wrong site label on the wrong tube.
• Wrong swab type, such as using a flocked swab instead of the required woven swab.
• Visible stool contamination on a rectal swab.
• Spilled transport media in the tube.
• Expired collection kit.
• Missing, incomplete, or mismatched requisition information.
• Specimen source not clearly identified.

If any of these happen, you'll need a new kit.

TeleTest offers two types of STI swab kits:

• Swab Kit (Subscription Required) - available as an add-on for patients with an active STI subscription, at reduced shipping cost.
• Swab Kit (Anal & Oral Swabs) - available to all patients without a subscription.

If you order the subscription-only kit without an active subscription, the order is reviewed and refunded automatically. To order without a subscription, select the Swab Kit (Anal & Oral Swabs) panel instead.