Gonorrhea (Neisseria gonorrhoeae) and chlamydia (Chlamydia trachomatis) are common sexually transmitted infections (STIs) that frequently present without noticeable symptoms. If left untreated, these infections can lead to severe health issues like pelvic inflammatory disease (PID) or infertility. Advancements in molecular testing, specifically Nucleic Acid Amplification Tests (NAATs), have made self-collected swab samples a highly reliable and private option for screening. The instructions for these kits must be followed exactly to ensure the sample contains enough genetic material for accurate analysis and to guarantee the viability of the specimen.
Preparing for the Test
Preparation steps are important to ensure the sample is collected correctly. First, locate a private, clean, and well-lit area where you can comfortably perform the swabbing without interruption. Next, thoroughly wash your hands with soap and water to prevent environmental contamination of the kit components.
Carefully examine the self-collection kit, ensuring that all components listed in the instructions are present, which typically includes the sterile swab and the transport tube containing a liquid medium. Verify the kit’s expiration date and confirm that all seals on the packaging are intact before use. If the kit includes instructions for a first-catch urine sample, note any timing constraints, such as avoiding urination for at least one hour before collection.
If you are a person with a vagina, avoid douching or using vaginal creams for at least 24 hours prior to the test, as these substances can interfere with the chemistry of the test and potentially lead to an inaccurate result. If any part of the kit appears damaged or if you accidentally drop the sterile swab tip, you must request a new kit to ensure sample integrity.
Detailed Swabbing Procedures
The collection procedure varies significantly depending on the anatomical site being tested. Self-collected vaginal swabs are the most common and highly sensitive method for people with a vagina. To collect a vaginal sample, hold the swab by the shaft and gently insert the soft tip about two inches (approximately 5 cm) into the vaginal opening. Once inserted, gently rotate the swab against the vaginal walls for 10 to 30 seconds to absorb moisture and collect cellular material.
Rectal Swab
For a rectal swab, the goal is to collect cells from the lining of the anal canal, not a stool sample. Lean over or squat in a comfortable position, and insert the soft tip of the swab approximately one to two inches (2-3 cm) past the anal sphincter. Gently rotate the swab a full 360 degrees for about 5 to 10 seconds, ensuring the tip makes contact with the rectal wall before carefully withdrawing it. Do not use any lubrication on the swab, as it may compromise the sample.
Pharyngeal (Throat) Swab
The collection of a pharyngeal (throat) swab requires precise targeting of the back of the throat and tonsils where the bacteria are most likely to reside. Open your mouth wide and use the swab to firmly rub across the back of the throat, moving across the tonsil area to the other side. Avoid touching the swab tip to the tongue, cheeks, or teeth, as this can introduce contaminants that interfere with the test.
Securing the Sample
Immediately after collecting the sample from any site, the swab must be placed into the transport tube containing the liquid medium. Carefully unscrew the cap from the tube, insert the swab tip into the liquid, and then break the swab shaft at the scored line. This line is designed to snap easily, leaving only the soft tip submerged in the transport medium. The transport medium stabilizes the DNA and RNA of the target organisms, which is crucial for the subsequent NAAT analysis.
Post-Collection Handling and Submission
Once the swab tip is submerged and the shaft has been broken off, the transport tube must be tightly capped to prevent leakage and maintain the integrity of the sample. Accurately label the specimen container with all required identifiers:
- Your full name
- Date of birth
- The specific collection site (vaginal, rectal, or pharyngeal)
- The exact date and time of collection
The labeled tube is typically placed inside a provided plastic biohazard bag, which often features a separate pocket for the completed paperwork. This ensures that the specimen is safely contained and separated from the requisition form. The completed requisition form, which may include details on any relevant symptoms or anti-microbial use, should be filled out completely to avoid processing delays at the lab.
The final step involves the logistical submission of the sample, which is often time-sensitive to ensure viability. Specimens must generally be transported to the laboratory without delay, often on the same day as collection. If a delay is unavoidable, the kit instructions will specify acceptable storage conditions, usually keeping the sealed tube at room temperature or refrigerated (2–30°C) until it can be shipped or dropped off at a designated facility.