Where to get screened for chlamydia

Prevalence in these groups is low. The false- positive, false-negative, false alarm, and false reassurance rates varied by anatomical site but were overall generally low across all NAATs and specimen types. No studies of psychosocial harms, such as anxiety, related to testing met inclusion criteria for this or prior reviews.

Several comments expressed concern that the USPSTF found insufficient evidence to screen men and did not provide separate recommendations for specific high-risk populations. The USPSTF did not identify enough evidence to support that screening men for chlamydia and gonorrhea improves health outcomes by reducing infection complications or disease transmission or acquisition, including HIV.

Some comments requested that universal, rather than risk-based, screening be recommended for women 25 years or older. Based on available disease prevalence data and accuracy of risk assessment tools, the USPSTF found that younger age was a strong predictor of disease risk, which was clarified in the Practice Considerations section.

Comments also asked for clarification on screening intervals. Given the lack of available evidence on optimal screening frequency, the USPSTF provides a reasonable approach for rescreening in the Practice Considerations section. Chlamydial and gonococcal infections are often asymptomatic in women. Untreated infections may progress to PID-related complications such as chronic pelvic pain, ectopic pregnancy, or infertility.

Infections may also be transmitted to sex partners and newborn children. Accurate screening tests and effective antibiotic treatments are available for chlamydia and gonorrhea. In men, gonococcal infections are more commonly symptomatic compared with women. Serious complications from infection are less common in men.

Studies on assessing risk and for whom screening may be most effective are a high priority. Studies evaluating the effectiveness of screening asymptomatic men to reduce infection complications and transmission or acquisition of either disease or HIV are needed.

Studies providing information on differential access and effective prevention strategies for these populations may help reduce racial and ethnic disparities. Studies with direct evidence on the effectiveness of screening pregnant persons, testing extragenital sites, cotesting for concurrent STIs, and screening intervals would help provide more information for best practices. The CDC recommends annual chlamydia and gonorrhea testing in all sexually active women younger than 25 years and in older women at increased risk of infection ie, those who have a new or multiple sex partners or a sex partner who has an STI.

It also recommends screening for both infections in pregnant women younger than 25 years and in older pregnant women at increased risk for infection during their first prenatal visit and again during their third trimester if risk remains high.

The CDC recommends that clinicians consider screening for chlamydia in sexually active young men in high-prevalence areas and populations. It recommends annual screening for chlamydia and gonorrhea at appropriate anatomical sites of exposure in men who have sex with men, with more frequent screening if risk behaviors persist or if they or their sex partners have multiple partners.

The CDC recommends screening transgender individuals on the basis of their sexual practices and anatomy. Because of high rates of STIs in persons entering correctional facilities, the CDC recommends chlamydia and gonorrhea screening at intake in correctional facilities in women 35 years or younger and in men younger than 30 years.

Because of the high likelihood of reinfection, the CDC recommends retesting all patients diagnosed with chlamydial or gonococcal infections 3 months after treatment, regardless of whether they believe their partners have been treated. However, it recommends that all pregnant women be tested for chlamydia early in pregnancy, with a repeat test in the third trimester for women with risk factors.

It recommends testing for gonorrhea in pregnant women 25 years or younger or for those living in an area where gonorrhea is common. Corresponding Author: Karina W. Barry, MD; Carol M. Wong, MD. Author Contributions: Dr Davidson had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. AHRQ staff had no role in the approval of the final recommendation statement or the decision to submit for publication.

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. All rights reserved. Our website uses cookies to enhance your experience.

By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Download PDF Comment. Clinician Summary: Screening for Chlamydia and Gonorrhea. View Large Download. Audio Author Interview Subscribe to Podcast. This systematic review to support the US Preventive Services Task Force Recommendation Statement on screening for chlamydial and gonococcal infections summarizes published evidence on the benefits and harms of screening for chlamydial and gonococcal infection in adults and adolescents, including those who are pregnant.

Griffin, MS; Heidi D. Save Preferences. Privacy Policy Terms of Use. Limit characters. Limit 25 characters. Conflicts of Interest Disclosure Identify all potential conflicts of interest that might be relevant to your comment. Err on the side of full disclosure. Yes, I have potential conflicts of interest. No, I do not have potential conflicts of interest. Limit characters or approximately words. The following information is required and must be completed in order to submit a comment:.

Thank You. Your comment submission was successful. Please allow up to 2 business days for review, approval, and posting. This Issue. Views 13, Citations 1. View Metrics. Twitter Facebook More LinkedIn. September 14, Article Information. Summary of Recommendations. Practice Considerations.

Patient Population Under Consideration. Assessment of Risk. Screening Tests. Screening Intervals. Treatment or Interventions. Additional Tools and Resources. Suggestions for Practice Regarding the I Statement. Chlamydial infections are 10 times more prevalent than gonococcal infections in young adult women.

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.

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. 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.

The same specimen can be used to test for chlamydia and gonorrhea. 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. 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. Potential Preventable Burden. 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. Potential Harms. 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. Current Practice. A review of health care claims of 4, 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 Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. More Information Urinalysis. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter.

Show references WHO guidelines for the treatment of Chlamydia trachomatis. World Health Organization. Accessed Jan. Cohen J, et al. Chlamydia trachomatis infection. In: Infectious Diseases. Elsevier; Chlamydia, gonorrhea, and nongonococcal urethritis. Mayo Clinic; Chlamydia: CDC fact sheet detailed. Centers for Disease Control and Prevention. Related Associated Procedures Urinalysis.