What is the standard procedure for a sexually transmitted disease (STD) screen?

From the Guidelines

A standard STD screen should include tests for chlamydia, gonorrhea, syphilis, and HIV, with screening frequency of at least every 3-6 months for individuals with multiple partners or higher risk behaviors, as recommended by the CDC 1. The basic screen involves urine samples for chlamydia and gonorrhea, blood tests for HIV and syphilis, and sometimes physical examinations for visible symptoms. Additional tests may include hepatitis B and C, herpes, and trichomoniasis depending on risk factors. Key considerations for screening include:

• Screening for gonorrhea and chlamydia at anatomic sites of exposure and syphilis every 3–6 months per CDC STI treatment guidelines recommendations for screening men who have sex with men and transgender women 1
• For persons without HIV receiving HIV PrEP, screen per CDC HIV PrEP guidelines, and for persons without HIV infection not receiving HIV PrEP, consider screening for STIs and HIV infection every 3–6 months 1
• Assess for the need for HIV PEP and encourage the use of HIV PrEP, and confirm or encourage linkage to HIV care for persons living with HIV infection 1 Testing frequency and types of tests may vary based on individual risk factors and behaviors. Early detection allows for prompt treatment, preventing complications like infertility, chronic pain, and transmission to partners. Most STIs are easily treatable with appropriate antibiotics or antiviral medications when caught early. It's essential to follow the CDC's guidelines for screening and treatment to ensure the best outcomes for individuals at risk of STDs. The CDC's recommendations are based on the most recent evidence and expert consensus, making them a reliable guide for clinicians and individuals seeking STD screening 1.

From the Research

Screening for Sexually Transmitted Diseases

• The US Preventive Services Task Force 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.
• The US Preventive Services Task Force 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.
• Screening for chlamydia and gonorrhea is important because these infections can lead to serious health problems, such as pelvic inflammatory disease and increased risk of acquiring or transmitting HIV 2.

Diagnosis and Treatment of Sexually Transmitted Infections

• Nucleic acid amplification tests have high sensitivities and specificities for the diagnosis of gonorrhea, chlamydia, and other sexually transmitted infections 3.
• Ceftriaxone, doxycycline, and penicillin are effective treatments for gonorrhea, chlamydia, and syphilis, respectively 4, 5, 3.
• Antimicrobial resistance limits oral treatment options for gonorrhea and Mycoplasma genitalium 3.

Populations at High Risk for Sexually Transmitted Infections

• Populations with higher rates of sexually transmitted infections include people younger than 25 years, sexual and gender minorities, and racial and ethnic minorities 3.
• Approximately 70% of infections with herpes simplex virus and trichomoniasis and 53% to 100% of extragenital gonorrhea and chlamydia infections are asymptomatic or associated with few symptoms 3.

Recommendations for Screening

• The Centers for Disease Control and Prevention provide updated, evidence-based testing and treatment recommendations for sexually transmitted infections 4.
• Screening recommendations only apply to asymptomatic individuals, and testing becomes diagnostic once an individual has symptoms 6.