Information for medical professionals

s.a.m health supports the healthcare system with expertise, advice and support

s.a.m health offers asymptomatic people with a history of sexually transmitted infections simple and discreet access to regular testing (screening) for HIV, syphilis, gonorrhea and chlamydia infections.

Professional consulting

After the initial registration, the first step is a consultation with an experienced counselor from a partner checkpoint of Deutsche Aidshilfe. During the consultation, it is evaluated whether s.a.m health is the ideal service for the interested party and at what interval tests for HIV and STIs are recommended based on the individual risk of infection.

People with symptoms of an STI should not be tested via s.a.m health - this is also part of the consultation - but are asked to visit a doctor's practice immediately.

In the event of a reactive or positive result, a further consultation will be carried out by the partner checkpoint with referral to medical care.

Quality-assured laboratory analysis

Laboratory tests for HIV, syphilis, gonorrhea and chlamydia are carried out in the same way as in private practice.

Test for HIV (AG/AK): Cobas 8000 test apparatus; Elecsys HIV Combo PT (Roche)

The 5th generation HIV screening test is a combination test for the detection of HIV-specific antibodies and p24 antigens. In the reactive case, the results of the antibody and antigen components of the test are shown separately. The screening test detects all groups and subtypes of HIV-1 and HIV-2.

An HIV antigen antibody test should be carried out at the earliest two weeks after sexual exposure. Six weeks after the risk contact, the result is considered sufficiently reliable (diagnostic window).

In the case of a reactive screening test, a confirmatory test is mandatory: either as an immunoblot (to show various antibodies against HIV-1/2 and/or as direct virus detection by means of nucleic acid detection (NAAT, e.g. as PCR). At s.a.m health, the confirmatory test is carried out from the retained sample without any additional costs for our users.

Lues (syphilis) test: TPPA with Serodia PR-PA (Fujirebio)

The Treponema pallidum particle agglutination test (TPPA test) is used as a screening test for people without a history of syphilis and detects both IgM and IgG antibodies. The TPPA test shows a reactive result at the earliest two to three weeks after infection. The exclusion of syphilis using the TPPA test is possible after ten weeks (diagnostic window).

If the results are reactive, the patient is referred to the doctor's practice for a confirmatory test for Treponema pallidum IgM and IgG antibodies and cardiolipin antibodies as markers of inflammatory activity. These complex tests require a venous blood sample - the capillary blood sample taken as part of the s.a.m. health test is not sufficient.

Lues (syphilis) test for known cured syphilis: RPR (Rapid Plasma Reagin Test) with Reditest (Biokit)

If syphilis is detected in the medical history during the initial consultation, a different test procedure is used in the laboratory. In these cases, the TPPA would be unsuitable as a screening test, as IgG antibodies are usually detectable in the TPPA test for life after syphilis has been cured. Recurrent syphilis can then be detected by detecting cardiolipin antibodies in the RPR test.

Detectable antibodies in the RPR test indicate syphilis requiring treatment. Cardiolipin antibodies can be detected in the serum around four to six weeks after a syphilis infection.

In the event of reactive findings, users in these cases are also referred to the doctor's practice during the consultation in order to carry out a confirmatory test for Treponema pallidum IgM and IgG antibodies and another test for cardiolipin antibodies (for titer control).

In the case of reinfection, IgM antibodies may be missing in the findings. Serological follow-up checks should be carried out 2-4 weeks after therapy and then at three-month intervals. A decrease in cardiolipin antibodies in particular by 3-4 titer levels within one year indicates effective therapy. These treatment and follow-up controls are not the aim of s.a.m health's test offer and users with a corresponding medical history are referred from the consultation to the doctor's practice.

Test for chlamydia and gonorrhea: NAAT with Cobas 4800 CT/NG test (Roche)

Nucleic acid detection (NAAT) is a reliable and rapid way of detecting or excluding Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG). Chlamydia trachomatis is the most widespread sexually transmitted bacterial pathogen. Double infections with gonococci (Neisseria gonorrhoea) occur in 10-30% of patients. Nucleic acid amplification techniques (NAAT) for CT and NG have a significantly higher sensitivity compared to culture, antigen tests and gene probe tests; in the case of NG, this applies in particular to extragenital localizations.

In addition to the urethra and cervix, the pharynx and rectum are other possible sites of infection. CT and NG infections in the pharynx and rectum are asymptomatic or have few symptoms in >90% of infected persons, but can still be passed on. Pathogen detection in the NAAT is not dependent on its vitality.

In the case of s.a.m. health, urethral diagnostics are carried out using first stream urine for people with a penis and a vaginal swab for people with a vagina. Swabs are also taken from the pharynx and rectum. In terms of sensitivity, there are no significant differences between first stream urine and urethral swabs in people with a penis. In people with vagina and uterus, vaginal and cervical swabs are considered equivalent.

The samples from all three swab locations are pooled in the laboratory for better cost efficiency. This means that in the event of a positive result, it is not possible to say from which localization the positive result originates. However, if an infection is detected, the treatment is the same for all three localizations.

In the case of a positive NG result, additional cultural evidence should be sought in medical practice due to the possibility of resistance testing.

Test for chlamydia and gonorrhea: NAAT with Cobas 4800 CT/NG test (Roche)

Accredited laboratory

"MVZ Labor Krone eGbR is a nationally and internationally active medical laboratory based in North Rhine-Westphalia and processes 15 - 20,000 human samples from all areas of medical care every day. 
The Labor Krone Group employs around 500 qualified staff in sample analysis (Labor Krone and LABCON-OWL), sample logistics (labcar-owl) and medical data management (IMEDAC). We offer comprehensive solutions for routine diagnostics in practices or clinics and for studies or research projects. In addition to efficient and quality-assured reporting, we offer the option of specialist medical advice in the areas of Microbiology Virology and Infection Epidemiology, Environmental Medicine and Hygiene, Internal Medicine, Immunology, Endocrinology, Neurology, Human Genetics and of course Laboratory Medicine. Furthermore, the entire laboratory is accredited by the German Accreditation Body (DAkkS) in accordance with DIN EN ISO 15189 (medical laboratory diagnostics).

The topics of research and development have a high priority at Labor Krone, both in the context of various collaborations and through scientific studies and work. The established study center handles all tasks that are not part of the laboratory routine. The employees of the study center are trained and certified according to ICH-GCP. Furthermore, the entire laboratory is also accredited as a testing laboratory (medical laboratory diagnostics in the context of clinical studies) in accordance with DIN EN ISO 17025. In addition, Labor Krone has a license for the laboratory tests required to obtain tissue in accordance with German medical law (§20b of the German Medicines Act (AMG))."

Trustworthy support and cooperation in the healthcare sector

Our service was developed with the needs of users and the challenges of the German healthcare system in mind. Demographic change, with an ageing and increasingly multi-morbid population, is being faced with a shortage of doctors. Both factors make it more difficult to secure long-term medical care.

s.a.m health supports doctors by relieving their daily workload. The regular STI and HIV screening service empowers asymptomatic patients with a risk profile and a high level of interest in (sexual) health to manage these themselves. In the event of an infection, our users are encouraged to visit a doctor's practice for treatment.

This allows doctors to focus more on the diagnosis of symptomatic patients and the treatment of infections detected (even earlier in the case of regular screening), while s.a.m health provides sexual health education and counseling as well as testing.

Transition from s.a.m. health to private practice medical care

At s.a.m health, positive or reactive test results are always communicated by telephone or in person. In this case, our users receive a text message asking them to call back or make an appointment. This allows our colleagues in the advice centers to respond to users in a reassuring and competent manner, clarify any questions that arise immediately and alleviate widespread fears.

We also collaborate with specialist practices and refer our users to doctors for treatment if they do not have a doctor they can contact directly.

In the event of a serious test result (HIV), our advisors will help you make an appointment at a specialist HIV practice and accompany you to the appointment if you wish.

Do you have further questions about s.a.m health? You will find many answers in our FAQ.

If you would like to offer s.a.m. health in your practice or have further medical questions about our services, please contact sam@dah.aidshilfe.de

1. Elecsys® HIV Duo. Immunoassay for the qualitative determination of HIV p24 antigen and antibodies to HIV / 
   Roche Diagnostics ↩︎
2. cobas 4800 CT/NG Test. Performance Characteristics / Roche Molecular Systems ↩︎
3. cobas 4800 CT/NG Test. Performance Characteristics / Roche Molecular Systems ↩︎
4. Treponema pallidum Line Immunoblot. Details. About Treponema pallidum and syphilis (Lues) / Fujirebio ↩︎
5. Rapid test for the qualitative and quantitative detection of syphilis in serum or plasma / company., B.A.W., RPR reditest ↩︎
6. Elecsys® HIV Duo. Immunoassay for the qualitative determination of HIV p24 antigen and antibodies to HIV / 
   Roche Diagnostics ↩︎
7. cobas 4800 CT/NG Test. Performance Characteristics / Roche Molecular Systems ↩︎
8. cobas 4800 CT/NG Test. Performance Characteristics / Roche Molecular Systems ↩︎
9. cobas 4800 CT/NG Test. Performance Characteristics / Roche Molecular Systems ↩︎
10. Rapid test for the qualitative and quantitative detection of syphilis in serum or plasma / company., B.A.W., RPR reditest ↩︎