What tests are recommended for a 26-year-old male (M) for preventative care in a clinic?

Preventive Screening for a 26-Year-Old Male

For a 26-year-old male at average risk, the essential preventive tests include HIV screening, blood pressure measurement, and verification of hepatitis B vaccination status, with additional sexually transmitted infection screening based on sexual activity and risk factors. 1

Mandatory Screening Tests

HIV Testing

• All males aged 13-64 years should be screened routinely for HIV infection using opt-out screening (testing performed as part of general medical consent unless patient declines). 1
• If sexually active with multiple partners or other high-risk behaviors (injection drug use, sex for money/drugs, men who have sex with men), rescreening should occur at least annually. 1

Blood Pressure Measurement

• Blood pressure should be measured at every clinical visit. 2, 3

Sexually Transmitted Infection Screening (Risk-Based)

For sexually active heterosexual males:

• Chlamydia screening should be considered if seen at sites with high prevalence (adolescent clinics, correctional facilities, STD clinics). 1
• Males with urethral discharge, dysuria, or whose partner has chlamydia should be tested and empirically treated. 1

For men who have sex with men (MSM):

• Screen for chlamydia at anatomic sites of exposure (urethral, rectal, pharyngeal). 1
• Screen for gonorrhea at anatomic sites of exposure (urethral, rectal, pharyngeal). 1
• Screen for syphilis at least annually; more frequent screening (every 3-6 months) if multiple/anonymous partners, methamphetamine use, or sex in conjunction with drug use. 1

Immunizations

HPV Vaccination

• Males aged 22-26 years may receive HPV4 vaccine if not previously vaccinated or have not completed the 3-dose series. 1
• This is optional for heterosexual males in this age range but recommended for MSM and immunocompromised males through age 26. 1

Hepatitis B Vaccination

• Verify vaccination status; offer routine hepatitis B vaccination if unvaccinated and no documented history of hepatitis B infection. 1

Baseline Laboratory Tests (Optional but Recommended)

Lipid Profile

• Begin lipid screening (total cholesterol, LDL, HDL, triglycerides) to establish baseline cardiovascular risk, particularly as standard screening begins at age 40. 2, 3
• Non-fasting samples are acceptable. 2, 3

Metabolic Screening

• Hemoglobin A1C testing is indicated if BMI ≥25 kg/m² with additional risk factors including: first-degree relative with diabetes, high-risk race/ethnicity, history of cardiovascular disease, hypertension, HDL <35 mg/dL, triglycerides >250 mg/dL, or physical inactivity. 2, 3

Complete Blood Count and Comprehensive Metabolic Panel

• CBC with differential and comprehensive metabolic panel can establish baseline values for kidney function, liver function, electrolyte balance, and screen for anemia or blood disorders. 2, 3

Cancer-Related Physical Examination

• A cancer-related checkup every 3 years for ages 20-39 should include examination of thyroid, testicles, lymph nodes, oral cavity, and skin. 1, 3
• Testicular self-examination awareness should be discussed. 1

Preventive Health Counseling

• Tobacco cessation counseling if applicable. 2, 3
• Diet and nutrition guidance. 2, 3
• Physical activity recommendations. 2, 3
• Alcohol and substance use assessment. 2, 3
• Depression and anxiety screening. 3

Tests NOT Recommended at Age 26

• Hepatitis C screening is NOT indicated unless high-risk factors present, as routine one-time screening is only for persons born 1945-1965. 1
• Colorectal cancer screening does NOT begin until age 45 for average-risk individuals. 2, 3
• Prostate cancer screening discussions do NOT begin until age 50 for average-risk men (age 45 for African American men or those with family history). 1, 2, 3

Common Pitfalls to Avoid

• Do not order extensive screening laboratory panels without clinical indication, as this leads to unnecessary costs and potential false-positive results requiring follow-up. 4, 5
• Do not skip HIV screening – this is a Grade A recommendation for all persons aged 13-64 years regardless of perceived risk. 1
• Do not assume all vaccinations are complete – verify hepatitis B and consider HPV vaccination status. 1
• Do not fail to assess sexual history and risk factors, as this determines need for STI screening. 1