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STD Urine Test: What It Can and Can't Detect

By Richard D. Porter, Patient Advocate Updated

Quick answer

A urine test is mainly used to find chlamydia and gonorrhea, and some trichomoniasis tests can use urine too. It can't find HIV, syphilis, hepatitis or herpes antibodies, which need a blood test, and it can't check your throat or rectum. For people with a vagina, the CDC says a vaginal swab is the best sample for chlamydia and gonorrhea, though urine is acceptable. For men, first-void urine is the best sample.

The test you need

Chlamydia: NAATRetest if negative before day 49

Gonorrhea: NAATRetest if negative before day 49

Trichomoniasis: NAATRetest if negative before day 49

Too earlyMay detect; retest if negativeReliable

Counted from your most recent exposure. CDC gives no single window for chlamydia, gonorrhea, trich or syphilis; the cautious date uses the NHS "up to 7 weeks". Work out your own dates

Test
Chlamydia and gonorrhea NAAT (urine)
Sample
First-void (first-catch) urine
When
The CDC treatment guidelines don't set a waiting time for these tests. A negative result can come too soon after exposure (MedlinePlus), so use the window-period calculator.
Results
STDCheck says its results are ready in 1 to 2 days

Giving a urine sample is the easiest part of STD testing. It only answers some of the questions, though, so it’s worth knowing which ones.

What can a urine STD test detect?

The main targets are chlamydia and gonorrhea. The CDC says NAATs, which look for the genetic material of the bacteria, are the most sensitive tests for chlamydia, and first-void urine is one of the accepted samples for gonorrhea.

Trichomoniasis can be detected in urine by some tests. The CDC lists Max CTGCTV2 as cleared for male and female urine, and GeneXpert as cleared for male urine. Aptima and Probe Tec aren’t cleared for men, so ask the lab which test it uses.

STDCheck, as an example of an online service, says its chlamydia and gonorrhea tests are urine tests, and its 13-test panel also uses urine for trichomoniasis and mycoplasma genitalium.

What can’t a urine test detect?

A urine test can’t find:

  • HIV. The CDC says HIV tests use blood or oral fluid.
  • Syphilis. Diagnosis uses blood (serologic) tests, according to the CDC.
  • Hepatitis B and C. The CDC describes blood tests for both.
  • Herpes. The CDC says the most sensitive test is a swab of a sore. Blood antibody tests are a separate option.
  • HPV. The CDC says HPV tests are cleared for cervical specimens only.

If your question includes any of these, you need a different sample. Our guide to STD blood tests covers them.

Can a urine test find throat or rectal infections?

No. The CDC says rectal and throat infections should be tested at the site of exposure, using swabs. The CDC adds that people who have had oral or anal sex should talk with a healthcare provider about throat and rectal testing options. A urine-only panel can come back negative while a throat or rectal infection goes unchecked.

Is a urine test or a swab better?

It depends on your anatomy:

  • Men: the CDC says first-void urine is an optimal sample for chlamydia and gonorrhea.
  • People with a vagina: the CDC says vaginal swabs are the optimal sample. Urine is also accepted, and you can collect the swab yourself, since the CDC says patient-collected vaginal swabs perform equivalently to clinician-collected swabs.

If you’re a transgender or nonbinary person, the CDC says screening should be adapted based on anatomy and exposure. A clinician can help you choose the right sample sites.

How do I prepare for a urine STD test?

Follow the lab’s instructions, since they differ. MedlinePlus says not to urinate for two hours before a gonorrhea urine test. STDCheck’s panel page says to avoid urinating for at least one hour before your visit. Either way, you collect the first part of your stream, not midstream.

Can I do a urine STD test at home?

For some infections, yes. MedlinePlus describes at-home gonorrhea kits that include a container for collecting a urine sample to send to a lab. The CDC says FDA-approved self-collection options are available for HIV, syphilis, chlamydia and gonorrhea, and that mailing a sample can take a few days. The CDC also says to talk openly with your healthcare provider about your sexual history and testing, even when you use a home kit.

What happens if a urine test is positive?

A clinician prescribes the treatment, which for these infections is antibiotics. MedlinePlus says a positive gonorrhea result means you need antibiotics right away and that your partner or partners need to be tested and treated. It says to avoid sex for at least 7 days after treatment. Reporting rules apply too: the CDC says chlamydia and gonorrhea are reportable to health departments in every state.

When should I take a urine test?

Timing matters. MedlinePlus says a negative result doesn’t fully rule out infection, since it can take weeks after exposure to test positive, and that the test may have been taken too soon. The CDC doesn’t give a fixed waiting time in its treatment guidelines, so check the window-period calculator and ask your provider.

After a positive result and treatment, the CDC says to retest about 3 months later. It also advises against NAATs within 4 weeks of finishing treatment for chlamydia.

Get care now if

  • You may have been exposed to HIV in the last 72 hours: go to an ER or urgent care now and ask about PEP
  • You have severe lower belly, pelvic or testicular pain, or a fever with pain: get care today instead of waiting for results
  • You are pregnant and think you may have been exposed: contact your prenatal clinician

Call 911 for a medical emergency. Otherwise, an urgent care clinic, sexual health clinic or your doctor can see you.

When to test

  1. Within 72 hours of a possible HIV exposureA urine test can't check for HIV. Go to an emergency room or urgent care now and ask about PEP. The CDC says PEP must be started within 72 hours.
  2. After a possible exposureA negative result can come too early, since it can take weeks after exposure to test positive. Use the window-period calculator, and ask the lab how long to wait.
  3. After treatmentThe CDC says to avoid NAATs within 4 weeks of finishing treatment for chlamydia, and to retest about 3 months after treatment.

Common questions

Can a urine test detect all STDs?

No. A urine test is used mainly for chlamydia and gonorrhea, and some NAATs can detect trichomoniasis in urine. HIV, syphilis, hepatitis and herpes antibody tests use blood. Herpes sores are tested with a swab of the sore.

How should I prepare for a urine STD test?

Follow your lab's instructions. MedlinePlus says not to urinate for two hours before a gonorrhea urine test, while STDCheck says to avoid urinating for at least one hour. You collect the first part of your stream in a cup.

How long do urine STD test results take?

It depends on the lab. STDCheck says its results are ready in 1 to 2 days. The CDC says mailed self-collection kits can take a few days.

Is a urine test as accurate as a swab?

For men, the CDC says first-void urine is an optimal sample. For people with a vagina, it says vaginal swabs are optimal, and the CDC notes that patient-collected vaginal swabs perform as well as clinician-collected ones.

Next: Chlamydia and gonorrhea NAAT (urine).

First-void (first-catch) urine. The CDC treatment guidelines don't set a waiting time for these tests. A negative result can come too soon after exposure (MedlinePlus), so use the window-period calculator.

Read next

Sources

This guide is general information written by a patient advocate using public health sources. It is not a diagnosis. Only a clinician or a lab test can tell you whether you have an infection. Read how we write and check our guides.