Ask Kim: Do I Need a Rectal Swab?

Dear Kim,

I read on HGLHC’s website that you do a rectal swab as part of your routine STI test. That seems kind of embarrassing to me! Do I really need a rectal swab?


Feeling Awkward

Dear Awkward,

This is actually a question we get a lot! We do recommend that most people get rectal swabs when getting a routine STI test. Some clinics don’t do rectal swabs routinely, but at HGLHC it’s an important part of STI testing. Here’s why.

There are three ways we test for gonorrhea and chlamydia – an oral swab, a urine sample, and a rectal swab. Gonorrhea and chlamydia can infect the mouth, rectum (butthole), and urethra (peehole). And get this: just because you’re negative in your urine and oral sample, doesn’t mean your rectal swab will come back negative! That’s right, you can have chlamydia or gonorrhea in ONLY the throat, urethra, or rectum. You’re at highest risk for rectal gonorrhea and chlamydia if you have condomless, receptive anal sex (bottoming), but it can also be transmitted to the rectum through oral-anal sex (rimming, tossing a salad).

There have been studies suggesting that chlamydia of the mouth can travel through the gastrointestinal system and infecting the rectum, so people who only have oral sex also may be at risk of rectal STI’s.

Whether to get a rectal swab is ultimately up to you, but at HGLHC we strongly recommend it for most people to make sure that we catch STI’s in any part of the body. This way, you can stay healthy and protect your partner(s)!

Be well, be yourself!

Kim Adamski

HIV Prevention Specialist

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