Std screening guidelines-USPSTF Recommendations for STI Screening - American Family Physician

The chart below summarizes recommendations regarding screening for sexually transmitted infections from three organizations: the American Congress of Obstetricians and Gynecologists ACOG , the U. The optimal interval for screening this population is not known; noted that CDC recommends annually. Screening for all pregnant women ages 24 and younger, and pregnant women over 24 who have risk factors e. Insufficient evidence to recommend screening in males. Centers for Disease Control and Prevention CDC All pregnant women Annual testing for all sexually active women under age 26 Women 26 and older women with risk factors new or multiple sex partners No routine testing for men, but consider screening men in high-prevalence settings correctional facilities, STD clinics.

Std screening guidelines

Std screening guidelines

Contact afpserv aafp. Physicians should consider xcreening demographics of the populations they serve in determining which STI screening tests to offer. If you're sexually active, particularly with multiple partners, you've probably heard the following advice many times: Use protection Std screening guidelines get tested. The primary rationale for screening all pregnant women is prevention of ophthalmia neonatorum. Do not routinely screen women and men who are not at increased risk for sexually transmitted infections. Pap smear: Still needed after hysterectomy?

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Close Updated Sections guideline title. Testing should be repeated as needed to protect the health of mothers and Std screening guidelines infants. At least annually for sexually active MSM 13 Every 3 to 6 months if at increased risk 7. Scrreening Std screening guidelines Opportunities. Your doctor tests you for syphilis by taking either a blood sample or a swab from any genital sores you might have. More News. Expect to feel various emotions. Choose a degree. Many Federal agencies Teens devotional lessons developed public awareness and education campaigns to address HIV prevention, treatment, care, and research. What can we improve?

If you are sexually active, getting tested for STDs is one of the most important things you can do to protect your health.

  • Assembly version: 1.
  • Cross-posted from U.
  • More information about the panels can be found in each set of guidelines.
  • If you are sexually active, getting tested for STDs is one of the most important things you can do to protect your health.
  • At least annually for sexually active MSM at sites of contact urethra, rectum regardless of condom use 6.
  • Sexually transmitted diseases are common, but the types of STD testing you need may vary by your risk factors.

Assembly version: 1. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U. Department of Health and Human Services. The USPSTF recommends screening for chlamydia in sexually active women age 24 years and younger and in older women who are at increased risk for infection. The USPSTF recommends screening for gonorrhea in sexually active women age 24 years and younger and in older women who are at increased risk for infection.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men. Go to the Clinical Considerations section for a description of populations at increased risk for infection and for suggestions for practice regarding the I statement.

The U. Preventive Services Task Force USPSTF makes recommendations about the effectiveness of specific clinical preventive services for patients without related signs or symptoms. It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms.

Chlamydia and gonorrhea are the most commonly reported sexually transmitted infections STIs in the United States. In , more than 1. Chlamydial infections are 10 times more prevalent than gonococcal infections 4. Although most identified cases are reported, the incidence of chlamydia and gonorrhea is difficult to estimate because most infections are asymptomatic and are therefore never diagnosed. The CDC estimates that more than , persons are infected with gonorrhea in the United States each year, and fewer than half of these infections are diagnosed and reported 3.

Chlamydial and gonococcal infections are often asymptomatic in women; however, asymptomatic infection may lead to pelvic inflammatory disease PID and its associated complications, such as ectopic pregnancy, infertility, and chronic pelvic pain. Newborns of women with untreated infection may develop neonatal chlamydial pneumonia or gonococcal or chlamydial ophthalmia. Infection may lead to symptomatic urethritis and epididymitis in men, although gonorrhea is more likely than chlamydia to be symptomatic in men compared with women.

Both types of infection may facilitate HIV transmission 1 , 4 , 5. The USPSTF found adequate direct evidence that screening reduces complications of chlamydial infection in women who are at increased risk, with a moderate magnitude of benefit. The USPSTF found adequate evidence that screening for gonorrhea results in a moderate magnitude of benefit based on the large proportion of cases that are asymptomatic, the effectiveness of antibiotic treatment to reduce infections, and the high morbidity associated with untreated infections.

The USPSTF found inadequate evidence that screening for chlamydia and gonorrhea reduces complications of infection and transmission or acquisition of either disease or HIV in men. The magnitude of benefit is unknown. The USPSTF concludes with moderate certainty that screening for chlamydia is associated with moderate net benefit in all sexually active women aged 24 years or younger and in older women who are at increased risk for infection.

The USPSTF concludes with moderate certainty that screening for gonorrhea is associated with moderate net benefit in all sexually active women aged 24 years or younger and in older women who are at increased risk for infection.

This recommendation applies to all sexually active adolescents and adults, including pregnant women. Age is a strong predictor of risk for chlamydial and gonococcal infections, with the highest infection rates occurring in women aged 20 to 24 years, followed by females aged 15 to 19 years.

Chlamydial infections are 10 times more prevalent than gonococcal infections in young adult women 2. Among men, infection rates are highest in those aged 20 to 24 years 1. Other risk factors for infection include having a new sex partner, more than 1 sex partner, a sex partner with concurrent partners, or a sex partner who has an STI; inconsistent condom use among persons who are not in mutually monogamous relationships; previous or coexisting STI; and exchanging sex for money or drugs.

Prevalence is also higher among incarcerated populations, military recruits, and patients receiving care at public STI clinics. There are also racial and ethnic differences in STI prevalence. In , black and Hispanic persons had higher rates of infection than white persons 1.

Clinicians should consider the communities they serve and may want to consult local public health authorities for guidance on identifying groups that are at increased risk. Gonococcal infection, in particular, is concentrated in specific geographic locations and communities.

Chlamydia trachomatis and Neisseria gonorrhoeae infections should be diagnosed by using nucleic acid amplification tests NAATs because their sensitivity and specificity are high and they are approved by the U. Food and Drug Administration for use on urogenital sites, including male and female urine, as well as clinician-collected endocervical, vaginal, and male urethral specimens 6. Most NAATs that are approved for use on vaginal swabs are also approved for use on self-collected vaginal specimens in clinical settings.

Rectal and pharyngeal swabs can be collected from persons who engage in receptive anal intercourse and oral sex, although these collection sites have not been approved by the U. Food and Drug Administration 7.

Urine testing with NAATs is at least as sensitive as testing with endocervical specimens, clinician- or self-collected vaginal specimens, or urethral specimens that are self-collected in clinical settings. The same specimen can be used to test for chlamydia and gonorrhea 7. In the absence of studies on screening intervals, a reasonable approach would be to screen patients whose sexual history reveals new or persistent risk factors since the last negative test result.

Chlamydial and gonococcal infections respond to treatment with antibiotics. Centers for Disease Control and Prevention guidelines for treatment of sexually transmitted diseases STDs and expedited partner therapy are available at www. Posttest counseling is an integral part of management of patients with a newly diagnosed STI. Posttest counseling can also serve as an educational opportunity for patients who present with STI concerns but test negative for infection.

It should address safe sex practices that can reduce disease transmission or reinfection; motivational interviewing strategies may also promote risk-reducing behaviors. To maximize adherence, the CDC recommends that drug treatment be dispensed on site.

The CDC recommends that all sex partners of infected patients from the preceding 60 days be evaluated, tested, and treated for infection. It also recommends that infected patients be instructed to abstain from sexual intercourse until after they and their sex partners have completed treatment and no longer have symptoms. For a sex partner who cannot be linked to care, the CDC suggests that clinicians consider expedited partner therapy, which allows for the delivery of a drug or drug prescription to the partner by the patient, a disease investigation specialist, or a pharmacy.

Because of a high likelihood of reinfection, the CDC also recommends retesting all patients diagnosed with chlamydial or gonococcal infection 3 months after treatment, regardless of whether they believe their partners have been treated.

In pregnant women, a test of cure to document eradication of chlamydial infection 3 weeks after treatment is recommended.

Pregnant women diagnosed with a chlamydial or gonococcal infection in the first trimester should be retested 3 months after treatment. Gonococcal neonatal ophthalmia, which can be transmitted from an untreated woman to her newborn, may be prevented with routine topical prophylaxis at delivery. However, prevention of chlamydial neonatal pneumonia and ophthalmia requires prenatal detection and treatment.

Chlamydial and gonococcal infections are often asymptomatic in men but may result in urethritis, epididymitis, and proctitis. Uncommon complications include reactive arthritis chlamydia and disseminated gonococcal infection. Infections at extragenital sites such as the pharynx and rectum are typically asymptomatic.

Chlamydial and gonococcal infections may facilitate HIV transmission in men and women 1 , 4 , 5. Potential harms of screening for chlamydia and gonorrhea include false-positive or false-negative results as well as labeling and anxiety associated with positive results. In , estimated direct lifetime costs in U. A review of health care claims of male and female patients presenting for general medical or gynecologic examinations from to found that a large proportion of those with high-risk sexual behaviors did not receive STI or HIV testing during their visit.

According to a review of diagnostic billing codes for patients with high-risk sexual behaviors, men were significantly less likely than women to be tested for chlamydia These recommendations are available at www. Its recommendations for STD prevention include clinical prevention guidance available at www. The CDC has also issued guidance for clinicians on how to take a sexual history available at www.

The Community Guide discusses interventions that have been efficacious in school settings and for men who have sex with men available at www. Canadian guidelines on STIs are available at www. Although the prevalence of chlamydia and gonorrhea differs, the risk factors for infection overlap and the USPSTF recommends screening for both simultaneously. Studies evaluating the effectiveness of different screening strategies for identifying persons who are at increased risk for infection, cotesting for concurrent STIs, and different screening intervals are needed to inform practice guidelines.

Studies evaluating the effectiveness of screening asymptomatic men to reduce the consequences of infection and transmission to sexual partners are needed. Identification of subgroups for whom screening may be effective is a high priority. Possible subgroups include men who have sex with men, sexually active males younger than 24 years, and men residing in high-prevalence communities. Currently, no studies provide data about the potential adverse effects of screening in any population.

However, its true incidence is difficult to accurately estimate because most infections are asymptomatic and are therefore undetected. In , the rate of chlamydial infection in females In , more than , cases of gonococcal infection were reported to the CDC 1. The majority of infections occurred in females aged 15 to 24 years and men aged 20 to 24 years.

The infection rate was similar for females and males The USPSTF commissioned a systematic review 7 , 11 of studies published since it previously reviewed these topics 12— Included studies had to be applicable to clinical settings and practices in the United States, as determined by the similarity of participants, health care services, and available screening tests. Conditions of interest included chlamydial and gonococcal infections in asymptomatic patients. The key questions are described in the systematic review 7 , The USPSTF found convincing evidence that available screening tests can accurately diagnose chlamydial and gonococcal infections.

Ten fair-quality studies on diagnostic accuracy 15—24 indicate that screening for chlamydia and gonorrhea with NAATs is highly accurate for specimens from various anatomical sites for women and men 7. In women, sensitivity of NAAT specimens varied slightly across endocervical specimens, clinician- or self-collected vaginal specimens, and urine specimens that were self-collected in clinical settings.

In men, testing of urine specimens was slightly more sensitive than testing of urethral specimens. Specificity was high across all specimens and tests for both chlamydia and gonorrhea 7. In 1 large RCT, a strategy of identifying, testing, and treating women at increased risk for cervical chlamydial infection was associated with significantly reduced incidence of PID relative risk [RR], 0.

Study limitations included a follow-up period of only 1 year, possible selection and ascertainment biases, and a relatively low participation rate. In another RCT, which was conducted in female high school students in Denmark, universal, 1-time, home-based screening was associated with a statistically significant reduction in the incidence of chlamydial infection RR, 0.

This study was rated as poor-quality because of significant loss to follow-up. Among asymptomatic women, 0. Study limitations included inadequate recruitment, testing for chlamydia outside the study protocol in nearly one quarter of participants, and difficulty in PID ascertainment.

These limitations may have attenuated intervention effects, and the study may have been underpowered.

Type 2 is the virus that causes genital sores more often. Give today. Was this page helpful? Sexually active women under 25 years of age 1 Sexually active women aged 25 years and older if at increased risk 2 Retest approximately 3 months after treatment 3. STI Prevention. Adult and Adolescent ARV.

Std screening guidelines

Std screening guidelines. AFP BY TOPIC

Nominate a Recommendation Statement Topic. Methods and Processes Procedure Manual. Standards for Guideline Development. Identifying Evidence Gaps. Conflict of Interest Disclosures. Archived: Recommendation Summary. Archived: Related Information for Consumers.

Archived: Related Information for Health Professionals. There is no related information for health professionals. Read the Full Recommendation Statement. Archived: Supporting Documents. Archived: Clinical Summary. Red Book : The authority on pediatric infectious diseases provides information on the epidemiology, evaluation, management, prevention, and treatment of HIV infection in adolescents.

Condom Use — Policy Statement. Contraception for Adolescents — Policy Statement. Contraception for Adolescents — Technical Report. The free app is available for Apple devices and Android devices. Sexual Health Resource Exchange - A web-based resource library that provides access to high quality, accurate, multi-media public awareness and education materials on sexually transmitted infections and other sexual health issues. Users can search for, view and download customizable public awareness and educational materials.

Users can also share their own resources using the easy-to-use upload process. The best way to prevent HPV is to get the vaccine in a series of 2 or 3 doses. The CDC recommends the vaccine is given to patients who are 11 or 12 years old. STI Prevention. Diagnostic Testing for STIs. Medications for Treatment of STIs. Find an STI testing site.

Testing Recommendations | American Sexual Health Association

The resources on this page provide information about the impact of STIs on youth as well as resources available for providing care to this population. Providers should address prevention, screening, and treatment of STIs with their sexually active adolescent and young adult patients as part of their regular annual health care visits.

Below are some resources and tools on STIs to help providers prevent, manage, and treat these infections. Types of Sexually Transmitted Infections.

There are many types of sexually transmitted infections STIs , but there are some that are more common in the adolescent and young adult population, which are listed below. Screenings for Adolescents and Young Adults Under 25 Years of Age : Annual chlamydia and gonorrhea screenings should be done for women under age 25 as well as older women who are at risk. Screening for syphilis, HIV, chlamydia, and Hepatitis B should be given to all pregnant women, and gonorrhea screening for pregnant women at risk.

Periodicity Schedule : Provides recommended screenings for each age. Red Book : The authority on pediatric infectious diseases provides information on the epidemiology, evaluation, management, prevention, and treatment of HIV infection in adolescents. Condom Use — Policy Statement. Contraception for Adolescents — Policy Statement. Contraception for Adolescents — Technical Report.

The free app is available for Apple devices and Android devices. Sexual Health Resource Exchange - A web-based resource library that provides access to high quality, accurate, multi-media public awareness and education materials on sexually transmitted infections and other sexual health issues.

Users can search for, view and download customizable public awareness and educational materials. Users can also share their own resources using the easy-to-use upload process. The best way to prevent HPV is to get the vaccine in a series of 2 or 3 doses.

The CDC recommends the vaccine is given to patients who are 11 or 12 years old. STI Prevention. Diagnostic Testing for STIs. Medications for Treatment of STIs. Find an STI testing site. You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Advertising Disclaimer. It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again. STI Screening Guidelines.

Types of Sexually Transmitted Infections There are many types of sexually transmitted infections STIs , but there are some that are more common in the adolescent and young adult population, which are listed below.

Std screening guidelines