Ask for testing at the rectal site if you have had anal sex or have rectal symptoms. A rectal swab commonly checks for chlamydia and gonorrhea; a urine or genital sample tests a different site. Depending on the clinic and test, a clinician may collect the swab or you may be able to collect it yourself.
What a rectal STI test checks
A rectal swab can test for chlamydia and gonorrhea in the rectum, often using a nucleic acid amplification test (NAAT). Each specimen represents a particular site: a urine or genital sample does not substitute for a rectal swab, and a throat swab checks another site. Tell the clinician which sites have been exposed so they can discuss appropriate tests. CDC guidance on STI testing recommends that people who have had anal sex talk with a healthcare provider about rectal testing options.
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A rectal swab is not a universal STI panel. Ask whether blood tests or tests at other exposed sites are also recommended; do not assume the swab checks for HIV, syphilis, or every other STI. Infections can have no symptoms, so testing may be offered even if you feel well. If you do have symptoms, describe what they are and when they began so the service can decide whether screening or diagnostic evaluation is appropriate.
Who should ask and how often
Recommendations depend on exposure, anatomy, and individual circumstances. The following intervals are US CDC guidance for specific groups, not a universal schedule:
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- Sexually active men who have sex with men: CDC recommends chlamydia and gonorrhea screening at sites of contact, including the rectum, at least annually.
- People at increased risk: Testing every 3 to 6 months may be appropriate. CDC includes people taking PrEP, people with HIV, and people or their partners who have multiple partners among those for whom more frequent testing may be appropriate.
- Women: Rectal chlamydia testing and rectal or throat gonorrhea screening can be considered based on reported behavior and exposure, through shared decision-making.
- Transgender and gender-diverse people: Screening should be adapted to anatomy and exposure.
See the CDC screening recommendations. Local guidance and access differ outside the United States.
How to request the test
You can be direct: “I’ve had anal sex and would like to know whether I need a rectal swab for chlamydia and gonorrhea.” A provider may ask about sexual practices and which anatomical sites were exposed to select tests. If you prefer, ask whether self-collection is available. Before the sample is taken, you can also ask:
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- Which infections and anatomical sites will this test cover?
- Can I collect the swab myself, and what instructions should I follow?
- How and when will I receive the result?
- Whom should I contact about results, treatment, or follow-up?
CDC’s testing guidance encourages an open conversation about sexual history and testing. You do not need to know in advance which specimen is right; describing your exposure helps the service advise you.
What happens during swab collection
The sample is collected from inside the rectum. Some clinics have a clinician collect it; others offer a private space where you collect your own sample. The process and what you are asked to do depend on the clinic and the specific test. CDC says a self-collected rectal swab is a reasonable alternative to a clinician-collected swab for chlamydia NAAT, but not every clinic offers self-collection or accepts every swab with every assay. CDC chlamydia guidance explains the recommendation.
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If you collect the swab yourself
Follow the instructions supplied by the clinic or kit, not a generic set of directions. Collection depth, how long to rotate the swab, tube handling, labeling, and how to return it can vary by kit and assay. Instructions commonly include washing your hands, avoiding contact with the soft swab tip, inserting the swab a short distance, gently rotating it against the rectal wall, and putting it into the supplied transport tube.
For example, Sexual Health Oxfordshire’s local kit instructions specify insertion 2–3 cm and rotation 5–10 times. Those measurements are for that kit, not universal instructions. Hologic’s Aptima collection instructions specify a different depth and duration. Use the instructions for the kit you were given.
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Do not substitute a retail swab or tube: the specimen must be compatible with the test. If you touch or drop the swab, spill the tube, or are unsure whether you collected the sample correctly, ask the clinic or laboratory what to do rather than guessing.
Finding a service and receiving results
Testing may be available from a healthcare provider or sexual-health clinic. In the United States, CDC’s Get Tested resource can help locate confidential and free or low-cost services. Some services offer self-collection kits for selected infections and specimens; availability depends on location. CDC says mailed self-collection tests can take a few days, but it does not give a universal turnaround time for rectal swab results. Ask the service how and when it will deliver your result.
If the result is positive, contact the service or a healthcare provider for treatment advice and guidance about partner notification and testing. Treatment and follow-up depend on the infection and your clinical circumstances. Ask what was included in your test and whether testing at other sites or for other infections is recommended.
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