To get tested for gonorrhea, give a first-catch urine sample (or a vaginal swab) plus a throat or rectal swab if you've had oral or anal sex, then run a NAAT — the same lab method used by clinics and at-home mail-in kits. Ask for every exposed site, or an infection gets missed.
test all exposed sites
500 mg IM, single shot
| Item | Value |
|---|---|
| Test method | NAAT — test all exposed sites |
| Treatment | ceftriaxone — 500 mg IM, single shot |
| Throat infection | harder to cure |
| Retest | 3 mo |
How gonorrhea is tested: the test and the sample
Gonorrhea is caused by the bacterium Neisseria gonorrhoeae, which can infect the genitals, rectum, and throat CDC. The standard test is a nucleic acid amplification test, or NAAT. It detects the bacterium's genetic material rather than trying to grow it, so it's both fast and accurate. NAAT is the preferred and effectively required screening method, with sensitivity usually above 90% and specificity around 99% CDC technical guidance. It rarely misses a true infection and rarely flags one that isn't there.
The sample depends on where you could have been exposed. For urogenital infection, a first-catch urine sample works for men and women, and a vaginal swab is an excellent alternative for women. For the throat and rectum, you need a pharyngeal or rectal swab; urine alone will never detect an infection at those sites. Patient-collected swabs are acceptable and perform well, so at-home and self-swab testing is reliable. Screen every anatomic site of sexual exposure, not just the genitals.
This is the single most common testing mistake. If you've had oral sex, your throat needs a swab; if you've had receptive anal sex, your rectum needs one. A urine-only test in someone with a throat infection comes back negative and the infection keeps spreading. For a fuller breakdown of each method and how results are reported, see our guide to the gonorrhea test.
When to test after exposure
No official CDC or USPSTF page reviewed states an exact post-exposure window for the gonorrhea NAAT or for when symptoms reliably appear. Because the test detects bacterial DNA, it generally becomes positive once the organism is established, but testing the same day as a risky encounter can be too early. A practical approach is to test once, and if the exposure was recent or symptoms develop, test again. For a wider look at timing across infections, read when to test after exposure.
Throat infections deserve a special note. Pharyngeal gonorrhea is usually symptomless and can persist for up to 16 weeks CDC, so a long quiet stretch doesn't mean you're clear. The throat hides infection without any sore-throat warning, so swab the site directly.
Who should get screened
The U.S. Preventive Services Task Force gives gonorrhea screening a Grade B recommendation for sexually active women who are 24 or younger, including pregnant people, and for women 25 and older who are at increased risk USPSTF, 2021. For men, the Task Force found the evidence insufficient to make a routine recommendation (Grade I). That doesn't mean men shouldn't test. Men with symptoms, men who have sex with men, and anyone with a partner who tested positive should still be tested, and site-specific swabbing matters most for this group.
- Sexually active women 24 or younger, including during pregnancy.
- Women 25 and older with risk factors such as a new or multiple partners, or a partner with an STI.
- Men who have sex with men — screen the throat, rectum, and urethra based on exposure.
- Anyone with symptoms or a known exposure, regardless of age or sex.
- Anyone living where rates run high — in 2023 the national rate was about 180 per 100,000, but it reached 853 in Washington DC, 311 in Alaska, and 288 in Louisiana CDC AtlasPlus.
For context, reported gonorrhea has actually been falling — roughly 601,000 cases in 2023, down from a 2021 peak. It's still common enough, and reinfection frequent enough, that routine screening pays off.
Getting tested: clinic visit vs. at-home kit
A clinic visit is quick. You'll provide a first-catch urine sample, and if you've had oral or anal sex, a clinician or you can collect a quick throat or rectal swab. Ask for every exposed site, since staff won't always know your history and an unstated site goes untested. Public and STI clinics often offer testing free or at low cost, and if a result is positive, the treatment shot can be given on-site the same day.
An at-home kit ships you the collection materials, you self-collect urine and any needed swabs, mail the samples to a lab, and get results online. Because patient-collected swabs are accepted for NAAT, a well-designed home kit can test the throat and rectum too, but only if the kit includes those swabs and you actually use them. A urine-only kit, when you've had oral or anal sex, makes the same site-coverage mistake. You can get tested through a mail-in option, and it helps to compare testing providers to find one that covers all three sites.
Reading your results
A NAAT result is reported per site as detected (positive) or not detected (negative). Given the test's high sensitivity and specificity, a negative result for a properly collected sample is reassuring for that site, but it only speaks to the sites you sampled. A negative urine test says nothing about your throat if your throat was never swabbed. A positive result means that bacterium is present at that location and you need treatment.
If you test positive
Gonorrhea is curable with the right antibiotic, though medicine can't reverse damage that has already occurred. Current first-line therapy is a single ceftriaxone injection; azithromycin was dropped as resistance climbed. Throat infections are harder to cure and call for a follow-up test-of-cure. For the full regimen and what to expect, see gonorrhea treatment. Plan to retest in 3 months too, because reinfection from an untreated partner is common.
When to see a clinician
See a clinician promptly if you have symptoms — unusual discharge, pain with urination, pelvic or testicular pain, rectal discomfort, or sore throat after oral sex — or if a partner tested positive. Don't wait out symptoms hoping they pass; untreated gonorrhea can climb the reproductive tract and cause lasting harm, which is why people ask does gonorrhea cause infertility in men & women?. Also see a clinician if a home test comes back positive, so you can start the injection and arrange any needed test-of-cure.