Sexually transmitted infections (STIs)

Laboratory tests

• HIV serology
• Syphilis serology
• Hepatitis C serology
• Hepatitis B serology (HBsAg, anti-HBs antibodies, anti-HBc antibodies)

On self-collected sample or first-catch urine

• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR)
• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR), 2 sites (depending on sexual practices)if neededAnal or oro-genital intercourse: also sample the anus and/or throat; the 2- or 3-site procedure replaces the 1-site one (the three cannot be combined) and requires an explicit prescription ^[2].
• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR), 3 sites (depending on sexual practices)if neededAnal or oro-genital intercourse: also sample the anus and/or throat; the 2- or 3-site procedure replaces the 1-site one (the three cannot be combined) and requires an explicit prescription ^[2].
• Mycoplasma genitalium NAAT (PCR)if neededSymptoms of urethritis or cervicitis (2nd-line test if Chlamydia and gonococcus PCR are negative ^[3]), recurrent or persistent symptoms, current partner of an infected person, or follow-up test if symptoms persist 3 weeks after the end of treatment; never as screening in a person without symptoms ^[4].
• These PCRs can be done on several sites depending on sexual practices and exposure (vagina or first-catch urine, anus, throat): 2 sites (procedure code 5302) or 3 sites (procedure code 5303), on explicit prescription.

Urine tests

• Urine microscopy and culture (if post-coital cystitis)if neededRecurrent post-coital cystitis: urine microscopy and culture at the first recurrences ^[5] and before starting antibiotic prophylaxis ^[5,6].

At the laboratory, at the patient's request, without prescription or appointment (“Mon test IST”)

• HIV serology (at any age, 100% reimbursed in France)
• Syphilis serology (treponemal test, then titrated non-treponemal test if positive)
• Hepatitis B serology (HBsAg, anti-HBs, anti-HBc)

On self-collected vaginal or anal sample, or first-catch urine (pharyngeal sample possible by a professional)

• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR), 1 site
• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR), 2 sites (depending on sexual practices)if neededAccording to sexual practices (anal or oro-genital intercourse); replaces the 1-site PCR, the three procedures not being combinable ^[13,24].
• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR), 3 sites (depending on sexual practices)if neededAccording to sexual practices (anal or oro-genital intercourse); replaces the 1-site PCR, the three procedures not being combinable ^[13,24].
• No prescription to write: the patient goes directly to the laboratory. Hepatitis C and Mycoplasma genitalium are not included.

Laboratory tests

• HIV serology
• Hepatitis C serology
• Syphilis serology (if exposure)if neededExposed person: man who has sex with men and unprotected intercourse (including oral sex), other diagnosed STI, sex work (or clients), several partners in the year without a condom, origin from an endemic area, incarceration, rape ^[28]; at least once a year in case of recurrent risk-taking ^[29]; every 3 months on PrEP, with screening for other STIs ^[30].
• Hepatitis B serology (HBsAg, anti-HBs antibodies, anti-HBc antibodies) (if exposure or before vaccination)if neededExposed person (risky sexual behaviour, partner of a chronic carrier, origin from a high-endemicity area, drug use): look for carriage before offering vaccination ^[28].

On self-collected vaginal sample, first-catch urine or anal or pharyngeal swab

• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR), 1 site (if woman aged 15 to 25 or risk factor)if neededWoman aged 15 to 25 inclusive (including pregnant): routine screening; others: man or woman over 25 with a risk factor, pregnant woman attending for a termination of pregnancy ^[12]. Vaginal sample preferred in women ^[12].
• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR), 2 sites (depending on sexual practices)if neededAnal or oro-genital intercourse: also sample the anus and/or throat, to be requested explicitly (procedures 5302 and 5303); the HAS considers reimbursement of the three sites according to sexual practices necessary ^[12]. Replaces the 1-site PCR.
• Chlamydia trachomatis and Neisseria gonorrhoeae NAAT (PCR), 3 sites (depending on sexual practices)if neededAnal or oro-genital intercourse: also sample the anus and/or throat, to be requested explicitly (procedures 5302 and 5303); the HAS considers reimbursement of the three sites according to sexual practices necessary ^[12]. Replaces the 1-site PCR.
• Sites to sample depending on practices and exposure: vagina or first-catch urine, anus, throat (2 sites: procedure code 5302; 3 sites: procedure code 5303, on explicit prescription).