What is included in a standard Sexually Transmitted Disease (STD) panel?

Standard STD Panel Components

A standard STD panel typically includes testing for chlamydia, gonorrhea, HIV, and syphilis, which are the core infections recommended for routine screening in at-risk individuals. 1

Core Components of STD Panel

• Chlamydia testing: Recommended annually for all sexually active women aged ≤25 years and for older women with risk factors (new or multiple partners). For men, screening is recommended in high-prevalence settings and for men who have sex with men (MSM) at anatomic sites of exposure 1

• Gonorrhea testing: Recommended annually for all sexually active women aged <25 years and older women at increased risk. For men, screening is recommended based on risk factors and in high-prevalence settings 1

• HIV testing: Recommended for all persons at risk of STDs (sexually active and not in a mutually monogamous relationship with an uninfected partner) 1

• Syphilis testing: Recommended for individuals with high-risk sexual behavior and in communities with high prevalence 1

Additional Tests Often Included

• Hepatitis B surface antigen (HBsAg): Particularly important in pregnant women and high-risk individuals 1

• Hepatitis C: Testing recommended based on CDC guidelines, particularly for high-risk populations 1

• Trichomoniasis: Often included in testing for women, especially those with symptoms or high risk 1, 2

Population-Specific Considerations

For Women

• Standard screening should include chlamydia and gonorrhea for sexually active women under 25 years 1
• Trichomoniasis testing is often added for women with symptoms or risk factors 1
• Bacterial vaginosis testing may be included when vaginal discharge or odor is present 1

For Men

• Screening recommendations vary based on risk factors and sexual behaviors 1
• MSM should receive more comprehensive testing including rectal and pharyngeal sites for chlamydia and gonorrhea 1

For Pregnant Women

• More comprehensive screening is recommended, including mandatory syphilis, HIV, and hepatitis B testing 1
• Chlamydia screening for all pregnant women ≤25 years and older pregnant women with risk factors 1

Testing Frequency

• Annual screening is recommended for most at-risk populations 1
• More frequent testing (e.g., every 3-6 months) may be appropriate for individuals with ongoing high-risk behaviors 1
• Rescreening at 3 months after treatment is recommended for those diagnosed with chlamydia or gonorrhea 1

Common Pitfalls in STD Screening

• Underscreening: Many infections are asymptomatic and go undetected without proper screening 1, 2
• Inadequate anatomic site testing: Failure to test extragenital sites (pharyngeal, rectal) in MSM can miss infections 1
• Inconsistent co-testing: Recent data shows high rates of co-infection between certain STIs, particularly syphilis with chlamydia (21%) and gonorrhea with chlamydia (23%), highlighting the importance of comprehensive testing 2
• Relying on symptoms: Most STIs are asymptomatic, making screening essential rather than symptom-based testing 3

Modern multiplex PCR testing has improved the ability to test for multiple STIs simultaneously, increasing detection rates and efficiency 4. However, the specific components of an STD panel may vary by clinical setting, local prevalence, and patient risk factors.