What screening is recommended for a sexually active 17-year-old female with a history of regular menses, consistent condom use, and previous negative Human Immunodeficiency Virus (HIV), Neisseria gonorrhoeae (gonorrhea), and Chlamydia trachomatis (chlamydia) test results?

From the Guidelines

The correct answer is C. Chlamydia and gonorrhea. This 17-year-old sexually active female should be screened for chlamydia and gonorrhea at this visit, despite having negative results 6 months ago. The US Preventive Services Task Force and other major medical organizations recommend annual screening for chlamydia and gonorrhea in all sexually active females under age 25, regardless of symptoms or risk factors, as stated in the study by 1. This is because these infections are often asymptomatic but can lead to serious complications like pelvic inflammatory disease, chronic pelvic pain, and infertility if left untreated. The high prevalence of these infections in adolescents and young adults justifies routine screening. While the patient had negative tests 6 months ago, annual screening is still recommended due to the possibility of new infections, as supported by the guidelines from the American Congress of Obstetricians and Gynecologists 1 and the American Academy of Pediatrics 1.

Some key points to consider:

• The patient's age and sexual activity put her at risk for chlamydia and gonorrhea, as noted in the study by 1.
• The US Preventive Services Task Force recommends annual screening for chlamydia and gonorrhea in all sexually active females under age 25, as stated in the study by 1.
• Other options, such as screening for ADHD, cervical dysplasia, depression, or iron deficiency anemia, are not indicated based on the information provided, as they are not directly related to the patient's sexual activity or age, as discussed in the study by 1.
• Regular screening for STIs is indeed required for sexually active adolescents and young adults, as emphasized by the American Academy of Family Physicians 1 and the Canadian guidelines 1.
• The patient's well-varied diet and normal previous CBC make iron deficiency screening unnecessary, as noted in the study by 1.
• The patient is too young for cervical cancer screening, which typically begins at age 21, as stated in the study by 1.

Overall, screening for chlamydia and gonorrhea is the most appropriate choice for this patient, given her age, sexual activity, and the recommendations of major medical organizations, as supported by the studies by 1.

From the Research

Screening Recommendations

The patient is a 17-year-old girl who is sexually active and has been using condoms consistently. Based on the provided evidence, the following screening recommendations can be made:

• The US Preventive Services Task Force (USPSTF) recommends screening for chlamydia in all sexually active women 24 years or younger and in women 25 years or older who are at increased risk for infection 2, 3, 4.
• The USPSTF also recommends screening for gonorrhea in all sexually active women 24 years or younger and in women 25 years or older who are at increased risk for infection 2, 3, 4.
• Since the patient is 17 years old and sexually active, she should be screened for chlamydia and gonorrhea, regardless of her reported consistent use of condoms 2, 3, 4.

Other Considerations

Other conditions that may be considered for screening in this patient include:

• Iron deficiency anemia, as the patient is a menstruating female and iron deficiency is a common cause of anemia in this population 5.
• Depression, as it is a common condition in adolescents and young adults, although there is no specific evidence provided to support screening in this patient.

Summary of Recommendations

Based on the provided evidence, the patient should be screened for:

• Chlamydia and gonorrhea, due to her age and sexual activity 2, 3, 4.
• Other conditions, such as iron deficiency anemia and depression, may also be considered for screening, although the evidence provided does not specifically support this in this patient 5.