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
  • 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