Self-collected lower vaginal swabs (LVS)
Attention
- Used to test for
- STIs
- Vaginal infections such as thrush (candida)
- Group B Streptococcus (GBS) in pregnancy
- HPV for cervical screening
- Always check the specimen collection guide from your clinic's pathology laboratory
What you need
- See Table 5.2 for swab types used for various samples and tests
- pH paper
Table 5.2 Sample and swab types for self-collected lower vaginal swabs
What you do
General procedure
- If more than one test being done (eg STI, vaginal infections, HPV) — number the swab packets/containers. STI swab is collected first
- 1 = Aptima or dry swab (STI)
- 2 = Amies transport medium swab (STI and other infections)
- 3 = Swab for HPV test
- Have woman wash her hands, then give her the required swabs
- For swab with transport medium (eg Aptima, Amies) — Remove container, leave swab in original packet. Do not give container to woman
- For dry swab — leave swab in original container, break seal
- Explain to woman she needs to have her legs apart — either
- Sitting on toilet — Figure 5.1
- OR Standing with 1 foot on toilet seat — Figure 5.2
- Give woman specific instructions for swabs needed
Small difference in method used for collecting STI and HPV swabs
- Put swabs on small tray or in paper bag — easier to manage and reduces environmental contamination
Figure 5.1
Figure 5.2
LVS for STI and other vaginal infections
Instructions for the woman
- Take first swab out of packet/container (numbered 1)
- Put tip of Aptima or dry swab about 2–4cm (length of 1–2 finger joints) inside vagina — Figure 5.3
- If Aptima swab — do not touch notched handle below groove
- Turn swab around once, leave in vagina, count to 10, remove — Figure 5.3
- Put Aptima swab back into packet OR dry swab back into container
Figure 5.3
- Take second swab out of packet (numbered 2)
- Repeat collection procedure as for first swab
- Put swab back into packet
- Use third swab if needed (numbered 3) — see LVS for HPV test for cervical screening
- Wash hands, return swabs to nurse or ATSIHP
When woman returns swabs
- Swab 1 (Aptima or dry swab)
- Take Aptima swab out of packet and put into Aptima tube. Break off handle at groove, do not touch section below groove. Put on cap
- OR make sure dry swab in transport tube and cap on
- Request 'LVS — chlamydia, gonorrhoea, trichomonas NAAT'
- Swab 2 (Amies transport medium swab)
- Take swab out of packet
- If doing pH test for trichomonas — touch swab on pH paper — see Vaginal discharge
- pH test unreliable if woman post-menopausal, semen or blood present
- Put swab into Amies transport medium tube
- If only doing STI check — request 'LVS — gonorrhoea culture'
- OR if also testing for vaginal infection (eg thrush, BV) — request ‘LVS — MC&S and gonorrhoea culture’
- Make sure swab containers correctly labelled, closed tightly
- Store and transport at room temperature
Combined lower vaginal and anal swab for GBS
Instructions for woman
- Take swab out of packet
- Put tip of swab about 2cm (length of 1 finger joint) inside vagina — Figure 5.4
- Turn swab around once, leave in vagina, count to 10, remove
- Put same swab about 2cm inside anus — Figure 5.4
- Turn swab around once, leave in anus, count to 10, remove
- Put swab back into packet
- Wash her hands, return swab to nurse or ATSIH
Figure 5.4
When woman returns swab
- Take swab out of packet, put into Amies transport medium tube
- Request 'LVS/anal — MC&S for GBS'
- Make sure swab container correctly labelled, closed tightly
- Store and transport at room temperature