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STD Screening Recommendations

  ** USPSTF recommends screening in adults and adolescents ages 15-65.

 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
Chlamydia
  • Sexually active age <25

    USPSTF1

  • Age 25 and older if at increased risk2

    USPSTF1

  • Retest approximately 3 months after treatment

    CDC3

  • All pregnant women <25

    USPSTF1

  • Pregnant women age 25 and older if at increased risk2

    USPSTF1

  • Retest 3rd trimester if age <25 or atrisk4

    CDC3

  • Pregnant women found to have chlamydial infection should have a test-of-cure 3-4 weeks after treatment and be retested within 3 months

    USPSTF1

  • Consider for young men in high prevalence clinical settings5 or in populations with high burden of infection (e.g. MSM)

    CDC6

  • At least annually for sexually active MSM at sites of contact (urethra, rectum) regardless of condom use

    CDC6

  • Every 3 to 6 months if at increased risk7

    CDC7

  • For sexually active, at 1st HIV evaluation, & at least annually thereafter

    CDC8

  • More frequent screening for might be appropriate depending on individual risk behaviors and the local epidemiology

    CDC8

 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
Gonorrhea

Sexually active age <25

USPSTF1
 

Age 25 and older if at increased risk9

USPSTF1
 

Retest 3 months after treatment

CDC10

All pregnant women less <25 and older women if at increased risk11.

USPSTF1
 

Retest 3 months after treatment

CDC10
 

 

At least annually for sexually active at sites of contact (urethra, rectum, pharynx) regardless of condom use

CDC10
 

Every 3 to 6 months if at increased risk7

CDC7

For sexually active, at 1st HIV evaluation, & at least annually thereafter.

CDC10
 

More frequent screening for might be appropriate depending on individual risk behaviors and the local epidemiology

CDC10

 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
Syphilis

 

 

All at 1st prenatal visit

USPSTF11
 

Retest early 3rd trimester & at delivery if at high risk

AAP/ACOG12

 

At least annually for sexually active

CDC13
 

Every 3 to 6 months if at increased risk7

CDC7

For sexually active, at 1st HIV evaluation, & at least annually thereafter

CDC, HRSA, IDSA, NIH14,15,16
 

More frequent screening for might be appropriate depending on individual risk behaviors and the local epidemiology

CDC13

 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
Trichomonas

Consider for persons receiving care in high-prevalence settings (e.g., STD clinics and correctional facilities) and for those at high risk for infection (e.g., persons with multiple sex partners, exchanging sex for payment, illicit drug use, and a history of STD) in high prevalence communities

CDC17

   

For sexually active women, at initial evaluation & annually

CDC14

 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
Herpes

Type specific HSV serologic testing should be considered for persons presenting for an STD evaluation (especially for those persons with multiple sex partners)

CDC17

Evidence does not support routine HSV-2 serologic screening among asymptomatic pregnant women. However, type-specific serologic tests might be useful for identifying pregnant women at risk for HSV infection and guiding counseling regarding the risk for acquiring genital herpes during pregnancy

CDC17

 

Type specific HSV serologic testing should be considered for persons presenting for an STD evaluation (especially for those persons with multiple sex partners)

CDC17

Evaluation for HSV-2 infection with type-specific serologic tests also can be considered if infection status is unknown in persons with previously undiagnosed genital tract infection.

CDC17

Type specific HSV serologic testing should be considered for persons presenting for an STD evaluation (especially for those persons with multiple sex partners), persons with HIV infection, and MSM at increased risk for HIV acquisition

CDC17

 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
HIV

All patients age 13-64 (opt-out)**

CDC18
 

All persons who seek evaluation and treatment for STDs.

CDC19

All pregnant women (opt-out)

USPSTF20
 

Retest 3rd trimester if at risk21

CDC21

All patients age 13-64 (opt-out)**

CDC18
 

All persons who seek evaluation and treatment for STDs.

CDC19

Annually for sexually active, if HIV status is unknown or negative and the patient himself or his sex partner(s) have had more than one sex partner since most recent HIV test

CDC22

 
 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
Cervical Cancer

Age 21-65 every 3 years with cytology; or for age 30-65, a combination of cytology & HPV testing every 5 years

USPSTF23,ACOG24,ACS25

As for all women

USPSTF23,ACOG24,ACS25

  

Cervical cytology screening for women twice (every 6 months) within first year after initial HIV diagnosis, then annually if results are normal

CDC, NIH, IDSA26

 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
Hepatitis B Screening

Those at increased risk

CDC27

Screen for HBsAg at first prenatal visit of each pregnancy regardless of prior testing

CDC27, USPSTF28

Those at increased risk

CDC27

Screen for HBsAg for all MSM

CDC27

Test for HBsAg and anti-HBc and/or anti-HBs.

CDC27

 WomenPregnant WomenMenMen Who have Sex With Men (MSM)Persons with HIV
Hepatitis C Screening

Those born between 1945-1965

CDC29, USPSTF30
 

if risk factors are present30

USPSTF30

Those born between 1945-1965

CDC29, USPSTF30
 

if risk factors are present30

USPSTF30

Those born between 1945-1965

CDC29
 

if risk factors are present30

USPSTF30

 

Those born between 1945-1965

CDC29
 

if risk factors are present30

USPSTF30
 

Yearly HCV testing in MSM with HIV infection

CDC31

Serologic testing at initial evaluation

CDC, NIH, IDSA32,33
 

Yearly HCV testing in MSM with HIV infection

CDC31

 References 

  1. LeFevre ML. Screening for Chlamydia and Gonorrhea: U.S. Preventive Services Task Force Recommendation Statement. Annals of internal medicine. Sep 23 2014.
  2. Those who have a new sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has a sexually transmitted infection.  Screening for Chlamydia and Gonorrhea: U.S. Preventive Services Task Force Recommendation Statement. Annals of internal medicine. Sep 23 2014.
  3. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  4. e.g., those with a new sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has a sexually transmitted infection. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  5. Adolescent clinics, correctional facilities, and STD clinics.  Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  6. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  7. More frequent STD screening (i.e., for syphilis, gonorrhea, and chlamydia) at 3–6-month intervals is indicated for MSM, including those with HIV infection if risk behaviors persist or if they or their sexual partners have multiple partners. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  8. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  9. Those who have a new sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has an STI. Additional risk factors for gonorrhea include inconsistent condom use among persons who are not in mutually monogamous relationships; previous or coexisting sexually transmitted infections; and exchanging sex for money or drugs. Clinicians should consider the communities they serve and may opt to consult local public health authorities for guidance on identifying groups that are at increased risk.  Screening for Chlamydia and Gonorrhea: U.S. Preventive Services Task Force Recommendation Statement. Annals of internal medicine. Sep 23 2014.
  10. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  11. US Preventive Services Task Force. Screening for syphilis infection in pregnancy: reaffirmation recommendation statement. Annals of internal medicine. 5/19/2009 2009;150(10):705-709.
  12. American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and March of Dimes Birth Defects Foundation. Guidelines for Perinatal Care. 6th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2007
  13. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  14. CDC, Health Resources and Services Administration, National Institutes of Health, HIV Medicine Association of the Infectious Diseases Society of America, HIV Prevention in Clincal Care Working Group. Recommendations for incorporating human immunodeficiency virus (HIV) prevention into the medical care of persons living with HIV. Clin Infect Dis. Jan 1 2004;38(1):104-121.
  15. Aberg JA, Gallant JE, Ghanem KG et al.  Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update by the HIV Medicine Association of the Infectious Diseases Society of America.  CID. Jan 1 2014;58: e1-e34.
  16. Centers for Disease Control and Prevention, Health Resources and Services Administration, National Institutes of Health, American Academy of HIV Medicine, Association of Nurses in AIDS Care, International Association of Providers of AIDS Care, the National Minority AIDS Council, and Urban Coalition for HIV/AIDS Prevention Services. Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States, 2014. 2014. http://stacks.cdc.gov/view/cdc/26062. December 11, 2014.
  17. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  18. CDC. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR. 9/22/2006 2006;55(No. RR-14):1-17.
  19. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  20. Moyer VA, US Preventive Services Task Force. Screening for HIV: US Preventive Services Task Force Recommendation Statement. Annals of internal medicine. 2013;159:51–60.
  21. Women who use illicit drugs, have STDs during pregnancy, have multiple sex partners during pregnancy, live in areas with high HIV prevalence, or have partners with HIV infection. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.
  22. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  23. Moyer VA. Screening for cervical cancer: US Preventive Services Task Force recommendation statement. Annals of internal medicine. Jun 19 2012;156(12):880-891, W312.
  24. American College of Obstetricians and Gynecologists (ACOG). Screening for cervical cancer. ACOG Practice Bulletin Number 131. Obstet Gynecol. Nov 2012;120(5):1222-1238.
  25. Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin. May-Jun 2012;62(3):147-172.
  26. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.Available at: http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf
  27. Those at increased risk include persons born in regions of high endemicity (>=2% prevalence), IDU, MSM, persons on Immunosuppresive therapy, Hemodialysis patients, HIV positive individuals, and others.  For detailed recommendations refer to: Centers for Disease Control and Prevention. Recommendations for Identification and Public Health Management of Person swith Chronic Hepatitis B Virus Infection,2008.  MMWR September 19th, 2008; 57(RR-8);1-21.  Available at: https://www.cdc.gov/mmwr/pdf/rr/rr5708.pdf
  28. U.S. Preventive Services Task Force. Screening for Hepatitis B Virus Infection in Pregnancy: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement. Ann Intern Med 2009;150:869-73
  29. Smith BD, Morgan RL, Beckett GA, et al. Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945-1965. MMWR. Aug 17 2012;61(No. RR-4):1-32.
  30. Past or current injection drug use, receipt of blood transfusion before 1992, long term hemodialysis, born to mother with Hep. C, intranasal drug use, receipt of an unregulated tattoo, and other percutaneous exposures. Moyer VA. Screening for hepatitis C virus infection in adults: US Preventive Services Task Force recommendation statement. Annals of internal medicine. Sep 3 2013;159(5):349-357.
  31. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015.  
  32. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.Available at: http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf
  33. Aberg JA, Gallant JE, Ghanem KG et al.  Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update by the HIV Medicine Association of the Infectious Diseases Society of America.  CID. Jan 1 2014;58: e1-e34.
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