What is the appropriate outpatient workup for a sexually transmitted disease (STD) panel?

From the Guidelines

The appropriate outpatient workup for a sexually transmitted disease (STD) panel includes annual testing for chlamydia among young sexually active females and routine testing for gonorrhea among all sexually active females at risk for infection 1.

Key Components of STD Workup

• Sexual health assessment: Explore the types of sexual activity, discuss current and future contraceptive options, and ask about current and previous use of methods 1.
• Testing for syphilis, HIV/AIDS, and hepatitis C: Conduct testing as recommended by the CDC 1.
• Vaccination for human papillomavirus (HPV) and hepatitis B: Offer vaccination as part of STD services and preconception care 1.

Screening Guidelines

• The US Preventive Services Task Force (USPSTF) recommends screening for chlamydia, gonorrhea, and syphilis in individuals at risk 1.
• The Centers for Disease Control and Prevention (CDC) publishes evidence-based STI screening recommendations for specific at-risk populations 1.

Partner Notification

• Partners of patients with STDs should be examined and treated if exposure to a treatable STD is considered likely, even if no clinical signs of infection are evident and laboratory test results are not yet available 1.

Additional Considerations

• Confidentiality and billing should be addressed when incorporating chlamydia screening into the office setting 1.
• Resources are available to support STD screening, including the National Chlamydia Coalition Web site and the CDC's STD treatment guidelines 1.

From the Research

Overview of STD Panel Workup

The appropriate outpatient workup for a sexually transmitted disease (STD) panel involves several key components, including:

• Eliciting a sexual history to understand the patient's risk factors 2
• Performing a physical examination to identify any signs or symptoms of STDs 3, 4
• Screening for common STDs such as chlamydia, gonorrhea, syphilis, and HIV 5, 2, 6

Screening Guidelines

The Centers for Disease Control and Prevention (CDC) and the US Preventive Services Task Force have issued guidelines for screening for STDs, including:

• Screening for chlamydia and gonorrhea in sexually active women under the age of 25 2
• Screening for syphilis and HIV in all patients, regardless of risk factors 3, 6
• Screening for other STDs, such as genital herpes and human papillomavirus, based on patient risk factors and symptoms 4

Laboratory Testing

Laboratory testing is an essential component of the STD panel workup, including:

• Nucleic acid amplification tests (NAATs) for chlamydia and gonorrhea 5, 4
• Serologic tests for syphilis and HIV 3, 6
• Other laboratory tests, such as cultures and PCR, may be used to diagnose other STDs 4

Treatment and Prevention

Treatment and prevention of STDs are critical components of the outpatient workup, including:

• Providing empiric treatment for patients with suspected STDs, particularly pregnant women 5
• Offering pre-exposure prophylaxis (PrEP) to patients at high risk of acquiring HIV 3
• Providing counseling on safe sex practices and condom use to prevent the transmission of STDs 3, 6