Recommended Clinician Timeline for Screening Syphilis, HIV, HBV, HCV, Chlamydia, and Gonorrhea

Clinician Timeline for Screening Syphilis, HIV, HBV, HCV, Chlamydia, and Gonorrhea
Clinician Timeline for Screening Syphilis, HIV, HBV, HCV, Chlamydia, and Gonorrhea

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[Illustration of an over-the-counter stick pregnancy test]

First Prenatal Visit

Syphilis: All pregnant women

HIV: All pregnant womeni

HBV: All pregnant womenii

Chlamydia: All pregnant women less than 25 years of age and older pregnant women at increased riskiii

Gonorrhea: All pregnant women less than 25 years of age and older pregnant women at increased riskiii

**HCV: Pregnant women at increased riskiv

[Illustration of pregnant woman supporting her lower back]

Third Trimester

Syphilis: Certain groups of pregnant womenv at 28 to 32 weeks

HIV: Certain groups of pregnant womenvi before 36 weeks

Chlamydia: Pregnant women less than 25 years of age or continued high riskiii

Gonorrhea: Pregnant women at continued high riskiii

[Illustration of baby wrapped in blanket]

At Delivery

Syphilis: Select groups of pregnant women,v pregnant women with no previously established status, or pregnant women who deliver a stillborn infant

HIV: Pregnant women not screened during pregnancy

HBV: Pregnant women not screened during pregnancy,vii who are at high risk,viii or with signs or symptoms of hepatitis

Endnotes

  1. To promote informed and timely therapeutic decisions, health care providers should test women for HIV as early as possible during each pregnancy.1
  2. All pregnant women should be tested for hepatitis B surface antigen (HBsAg) during an early prenatal visit (e.g., first trimester) in each pregnancy, even if they have been vaccinated or tested previously.2
  3. “Increased risk” means new or multiple sex partners, sex partner with concurrent partners, sex partners who have a sexually transmitted disease (STD).3,4
  4. “At increased risk” means injection-drug use (IDU), had a blood transfusion before July 1992, receipt of an unregulated tattoo, long-term hemodialysis, intranasal drug use, and other percutaneous exposures.3
  5. “Certain groups” includes women who are at high risk for syphilis or live in areas of high syphilis morbidity.3
  6. “Certain groups” includes women who receive health care in areas with an elevated incidence of HIV or AIDS among women aged 15-45 years, who receive health care in facilities in which prenatal screening identifies at least one HIV-infected women per 1,000 women screened, known to be at high risk for HIV (i.e., injection-drug user and their sex partners, exchange sex for money or drugs, sex partner of HIV-infected persons, have had a new or >1 sex partner during this pregnancy), or have signs or symptoms consistent with acute HIV infection.1
  7. Women admitted for delivery at a health care facility without documentation of HBsAg test results should have blood drawn and tested as soon as possible after admission.2
  8. Having had more than one sex partner during the previous 6 months, an HBsAg-positive sex partner, evaluation or treatment for a STD, or IDU.2

**The recommended timing for HCV screening has not been consistently recommended and is displayed during the first trimester for illustrative purposes. HCV screening can be done at any time for a woman with risk factors. For example, a women with risk factors presenting to care in the third trimester should be tested then, in the third trimester.
Note: United States Preventive Services Task Force Grade Recommendations guide insurance coverage for services. The most recent USPSTF grade recommendations for testing is “A” for Syphilis, HIV, and HBV, and “B” for HCV. For more information: Prevention Through Health Care: Preventive Services.

References
  1. Centers for Disease Control and Prevention. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 2006; 55(RR14):1-17.
  2. Centers for Disease Control and Prevention. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States pdf icon[PDF – 1 MB]. MMWR 2006; 54(RR16):1-32.
  3. Centers for Disease Control and Prevention. 2015 Sexually Transmitted Diseases Treatment Guidelines pdf icon[PDF – 7 MB]. MMWR Recomm Rep 2015;64(RR3):1-140.
  4. Centers for Disease Control and Prevention. STDs during Pregnancy – CDC Fact Sheet (Detailed). Accessed May 12, 2017.
Page last reviewed: May 22, 2019