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Investigations and microscopy

This chapter covers investigations and tests commonly used in sexual health. Some investigations can be performed on-site as the patient waits, such as urinalysis, pregnancy tests, and increasingly available point of care tests for infections such as HIV and, less commonly, the other blood-borne viruses, syphilis, Trichomonas vaginalis. On-site microscopy helps with diagnosis of genital candidiasis, bacterial vaginosis, N. gonorrhoeae infection, and T. vaginalis. Other investigations require sending samples away for laboratory testing of genital or ulcer swab, urine, or blood samples for STI and blood-borne viruses. This chapter explains the use of light and dark ground microscopy, near patient rapid test technologies, molecular methods such as nucleic acid amplification, culture and serology. Sensitivities and specificities of commonly available test kits are included.