Table 3

 Test(s) of choice in asymptomatic men who have sex with men (MSM)

Site or specimenGonorrhoeaChlamydiaNon-specific urethritisSyphilisHepatitis BHIV
NR, not recommended; NAAT, nucleic acid amplification test; EIA, enzyme immunoassay; TPPA, Treponema pallidum particle assay; TPHA, Treponema pallidum haemagglutination assay.
*Samples only appropriate if indicated by sexual history.
†If samples are taken from this site then culture should be used but NAAT may be considered if culture is not available.
‡NAATs are increasingly being used but remain unlicensed. Screening using NAATs should be offered in men who are contacts of lymphogranuloma venereum and guidance for more widespread rectal screening for chlamydia in MSM is still under review.
UrethraCultureNAATNRNRNRNR
Rectum*Culture†NAAT (in some situations‡)NRNRNRNR
Oropharynx*Culture†NRNRNRNRNR
UrineNAAT (if urethral specimen not available)NAATNRNRNRNR
BloodNRNRNREIA or TPPA or cardiolipin test plus TPHAEIA for HBsAg and anti-HBcAb and anti-HBsAbEIA