Recommended STI Panel for 18-Year-Old Males
For an 18-year-old male, the recommended STI panel should include screening for chlamydia, gonorrhea, HIV, and syphilis if he is sexually active and has risk factors. 1
Risk Assessment
The decision to screen should be based on:
- Sexual activity status - Is the patient sexually active?
- Risk factors:
- Multiple current partners
- New partners
- Inconsistent condom use
- Sex under influence of alcohol/drugs
- Sex in exchange for money/drugs
- History of STIs
- Men who have sex with men (MSM)
Recommended Screening Tests
For All Sexually Active 18-Year-Old Males with Risk Factors:
- Chlamydia - Urine NAAT (nucleic acid amplification test) 1
- Gonorrhea - Urine NAAT 1
- HIV - Serum testing 1
- Syphilis - Serum testing 1
Additional Site-Specific Testing for MSM:
- Pharyngeal gonorrhea - If engaging in receptive oral sex 1
- Rectal chlamydia and gonorrhea - If engaging in receptive anal intercourse 1
Screening Frequency
- Standard risk: Annual screening
- High risk (MSM with multiple/anonymous partners, sex with drug use): Every 3-6 months 1
Special Considerations
- Hepatitis B: Vaccination status should be verified and vaccination offered if not previously completed 1
- Hepatitis C: Consider screening if there are additional risk factors (IV drug use, HIV-positive) 1
- HPV: Vaccination is recommended through age 21 for all males 1
Important Caveats
- Unlike females under 25 years who should be routinely screened for chlamydia and gonorrhea regardless of reported risk factors, routine screening for males is not universally recommended unless risk factors are present 1
- Geographic location matters - areas with higher STI prevalence may warrant more aggressive screening approaches 1
- Racial/ethnic disparities exist in STI prevalence, which may influence screening decisions in certain communities 1
- HIV testing rates among adolescents with acute STIs are suboptimal (only about 55% in some studies), highlighting the importance of integrating HIV testing with STI screening 2
When Positive Results Occur
- Any positive STI test should prompt consideration for additional STI testing, as the presence of one STI increases risk for others 1
- Rescreening for chlamydia and gonorrhea should occur 3 months after treatment, regardless of whether partners were treated 1
The American Academy of Pediatrics and USPSTF both emphasize the importance of a comprehensive sexual history to guide appropriate specimen collection based on sexual behaviors, which should include inquiring about same- and opposite-gender sexual partners regardless of reported sexual orientation 1.