- • Most sexually transmitted diseases (STDs) are
asymptomatic. Persons with asymptomatic STDs are at risk for complications
and transmission of infection to others.
- • In some cases, screening is the only means to
detect and treat infection to prevent adverse outcomes.
- • The judicious use of screening tests relies on
appreciation of disease epidemiology and accurate assessment of
a patient’s sexual risk behavior.
Most sexually transmitted diseases are asymptomatic.
Patients often acquire infection from sex partners who exhibit no
symptoms. Persons with asymptomatic infection may develop complications
or sequelae without knowledge of being infected. The epidemiology
of STDs—how those diseases are distributed within a population—is
not random; risk factors that include age, gender, and sexual activity
dictate who is likely to be infected. Screening and timely treatment
have been shown to reduce the consequences of infection. National
organizations, including the US Preventive Services Task Force and
the Centers for Disease Control and Prevention (CDC), as well as professional
medical societies, regularly review the current scientific literature
and make evidence-based recommendations for STD and HIV screening.
Individuals are advised to undergo STD testing not only to identify
and treat asymptomatic infection (screening) but to monitor trends
in the population (surveillance) and confirm a diagnosis. Table
1–1 summarizes current STD and HIV screening recommendations.
Table 1–1. Recommendations for Sexually Transmitted Disease (STD) Screening.a |Favorite Table|Download (.pdf)
Table 1–1. Recommendations for Sexually Transmitted Disease (STD) Screening.a
|Cervical cancer||Centers for Disease Control and Prevention (CDC), US Preventive Services Task Force (PSTF)||All women who have been sexually active and have a cervix||Within 3 y of onset of sexual activity or age 21 (whichever comes first) and screening at least every 3 y||Routine screening for cervical cancer is not recommended in women older than 65 y if they have had adequate recent screening with normal Pap smears and are not otherwise at high risk for cervical cancer|
|Chlamydia||CDC, PSTF||All sexually active women aged 25 y and younger, and other asymptomatic women at increased risk for infection (Age important risk marker. Other patient characteristics associated with a higher prevalence of infection include being unmarried, African-American race, having a prior history of STD, having new or multiple partners, having cervical ectopy, and using barrier contraceptives inconsistently); sexually active men who have sex with men (MSM) should be screened at relevant anatomic sites (rectum) every 3–12 months||Yearly||More frequent screening may be required in those with increased risk, recent partners with chlamydia, and recent prior history of chlamydia. CDC recommends that all women treated for chlamydia undergo repeat testing 3 mo after treatment.|
|Genital herpes||CDC, PSTF||Persons with HIV infection and at increased risk for acquiring HIV infection,b and those with a sex partner known to have genital herpes||Yearly||Although serologic screening is not recommended in asymptomatic pregnant women at any time during pregnancy ...|