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Ask for testing at the rectal site if you have had anal sex or have rectal symptoms. Rectal swabs commonly test for chlamydia and gonorrhea; a urine or genital sample checks 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 check for chlamydia and gonorrhea at the rectal site, usually using a nucleic acid amplification test (NAAT). Each specimen represents the site it came from: a urine or genital sample does not substitute for a rectal swab, and a rectal swab is not a universal STI panel. Ask whether you also need tests for other exposed sites or blood tests. CDC testing guidance and its screening recommendations describe site-specific testing.
Many STIs can cause no symptoms. If you do have symptoms, tell the clinician what they are and when they started; they can decide whether screening or a diagnostic evaluation is appropriate.
Who should ask about rectal testing, and how often?
Anyone with relevant anal exposure or rectal symptoms can ask whether rectal testing is appropriate. Screening recommendations depend on anatomy, exposure, and individual risk; the following intervals are US CDC recommendations for specific groups, not a schedule for everyone.
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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, including for some people taking PrEP, people with HIV, and people or partners who have multiple partners.
- 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.
Recommendations and access differ by location. See the CDC screening recommendations for the US guidance.
What to expect at the appointment
A provider may ask about sexual practices and which sites were exposed so they can choose the right tests. You can say: “I’ve had anal sex and would like to know whether I need a rectal swab for chlamydia and gonorrhea.” CDC encourages an open conversation about sexual history and testing. You can also ask:
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- Can I collect the rectal swab myself, or will a clinician collect it?
- Which infections and anatomical sites will this test cover?
- How and when will I receive my results, and whom should I contact about them?
The sample is collected from inside the rectum. Some clinics have a clinician collect it; others offer self-collection in a private space. CDC considers self-collected rectal swabs a reasonable alternative to clinician-collected swabs for chlamydia NAAT, but not every clinic offers self-collection or accepts every sample type. CDC chlamydia guidance explains the recommendation.
How self-collection works
Use only the collection kit and instructions provided by the clinic or laboratory. Instructions commonly involve washing your hands, avoiding contact with the soft swab tip, inserting the swab a short distance, gently rotating it against the rectal wall, and placing it in the supplied transport tube. Exact depth, rotation time, tube handling, labeling, and return steps depend on the kit and assay.
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For example, Sexual Health Oxfordshire’s local kit instructions specify insertion of 2–3 cm and 5–10 rotations. Hologic’s Aptima collection instructions specify a different depth and duration. These are kit-specific examples, not universal directions; follow the instructions that came with your own kit.
Do not substitute a generic retail swab or tube. The collection supplies 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.
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Where to get tested and what happens next
Testing may be available through a healthcare provider or sexual-health clinic. In the United States, the 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, but availability depends on location. CDC says mailed self-collection tests can take a few days; it does not give a universal turnaround time for rectal swab results. Ask your service how and when results will arrive.
If a result is positive, contact the service or a healthcare provider for treatment and advice about partner notification and testing. Treatment and follow-up depend on the infection and your clinical circumstances. Confirm what the test included: a rectal swab does not by itself establish whether you were tested for HIV, syphilis, or other STIs.
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