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6% (95% CI 97.6%-100%). For gonorrhea, 18 participants were positive by vaginal swab. The sensitivity of clean urine to diagnose gonorrhea was 94.4% (95% CI 72.4%-100%) and specificity was 99.7% (95% CI 98.0%-100.0%). The sensitivity of dirty urine to diagnose gonorrhea was 100% (95% CI 79.3%-100%) and specificity was 99.7% (95% CI 98.0%-100%). Specificity of clean urine was noninferior compared with dirty urine for diagnosing chlamydia (p= .0004) and gonorrhea (p .0001). Clean urine samples may be an alternative option to diagnos