Throat and rectal STI tests: what to ask for

Why the sample site matters

Infections live where they were passed to. Gonorrhoea and chlamydia can settle in the throat after oral sex, or in the rectum after anal sex, without ever showing up in a urine sample or a genital swab.

They very often cause no symptoms at those sites. So there's nothing to prompt you to mention it — which is exactly how it gets missed.

A negative result only covers the places that were sampled. That's the whole point of this page.

What decides whether you get swabbed there

Your sexual history — the conversation at the start of the appointment. The HSE's guidance for GPs is explicit that "throat and rectal swabs should be guided by sexual history taking", and that the type of contact and the sites of exposure should be established.

So the conversation is part of the test. If oral or anal sex doesn't get mentioned, those swabs may not happen.

What to say

You don't need medical words and you don't owe anyone your life story. One sentence does it:

• "I've had oral sex — can you test my throat?"
• "I've had anal sex — can I have a rectal swab?"
• "Can you test everywhere, not just the usual?"
• If you'd rather not say much: "Please test all sites."

And one worth asking on the way out: "Which sites did you actually test?" Then you know what your result covers.

You can usually take the swab yourself

If the idea of someone else doing it is what's putting you off — you often don't have to. HSE guidance says a self-collected swab can be used, that self-testing is appropriate for anyone without symptoms, and that "vulvovaginal swab, first void urine, rectal and pharyngeal swabs are all suitable for self-collection."

Pharyngeal means throat. Ask whether you can do your own.

Home kits: the answers you give decide what arrives

The free HSE home test is ordered through SH:24, and SH:24's online consultation decides which tests you're sent based on your answers.

So the questions about oral and anal sex aren't small talk — they're what determines whether throat and rectal swabs are in the box. Answer them straight. Nobody is reading them to judge you; they're being read to build your kit.

If a kit arrives without a swab you expected, or you're not sure what's in it, contact SH:24 directly. We can't change an order — we're not the service.

If you're dreading saying it out loud

Sexual health staff have this conversation all day, every day. There is no version of your sex life that is new to them, and none of it changes how you're treated.

If you'd still rather not talk, a home kit lets you answer the same questions by typing them into a form instead. Both routes get you tested. Pick whichever one you'll actually do.

More on the appointment itself: your first STI test, what to expect.