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Objectives We sought to determine positivity rates for participants in the GetaKit study who identified as asymptomatic contacts of Neisseria gonorrhoeae (NG) and/or Chlamydia trachomatis (CT). Our goal was to shed light on current discrepancies between international sexually transmitted infection (STI) guidelines, some of which recommend blanket empiric treatment for all NG and CT contacts (eg, Canadian and United States guidelines) versus others which recommend waiting for positive results (BASHH, Australian, and European).Methods We extracted data for the period of 1 June 2023 to 30 June 2025 from GetaKit, which is a research website through which persons in Ontario, Canada can complete an online risk assessment and obtain access to laboratory-based testing for STIs, including NG, CT, HIV, syphilis and hepatitis C. From these data, we calculated positivity rates for NG and CT and the numbers needed to treat. We also evaluated for correlations of risk factors for testing positive.Results During our 25-month study period, participants ordered NG/CT testing 12 775 times. In a total of 6.7% of these orders, participants identified as an NG and/or CT contact. Positivity rates, for all completed testing, were 1.2% (n=115 diagnoses) for NG and 4.3% (n=395 diagnoses) for CT. Positivity among asymptomatic contacts ranged from 0% for NG in heterosexual males to 30.6% for CT in females who were ≤24 years old, with most positivity rates being <20% for both infections.Conclusions Our results suggest that blanket recommendations to treat or defer treatment seems inappropriate. More nuance is required. Empiric treatment of all NG and CT contacts will likely result in mass overuse of antibiotics. In contrast, deferring treatment seems inappropriate for asymptomatic females who are ≤24 years old and for anyone who cannot immediately obtain testing and treatment.