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Screening for STDs in Women

[print pdf 27kb] Updated 10/3/06

Chlamydia

  • In 2001 in their most recent statement on screening for Chlamydia, the United States Preventive Services Task Force (USPSTF) strongly recommends screening for Chlamydia in all sexually active women 25 years and younger, and other asymptomatic women at increased risk for infection.
  • Besides age, other patient characteristics associated with a higher prevalence of infection include being unmarried, African-American race, having a prior history of sexually transmitted disease (STD), having new or multiple sexual partners, having cervical ectopy, and using barrier contraceptives inconsistently.
  • According to the USPSTF: “The optimal interval for screening is uncertain. For women with a previous negative screening test, the interval for re-screening should take into account changes in sexual partners. If there is evidence that a woman is at low risk for infection (e.g., in a mutually monogamous relationship with a previous history of negative screening tests for chlamydial infection), it may not be necessary to screen frequently...”
  • Except in pregnant women, test-of-cure (repeat testing 3–4 weeks after completing therapy) is not recommended for persons treated with the recommended or alterative regimens, unless therapeutic compliance is in question, symptoms persist, or reinfection is suspected.
  • Recognizing that testing for reinfection is distinct from test of cure, clinicians should consider advising all women with chlamydial infection to be retested approximately 3 months after treatment. Providers also are strongly encouraged to retest all women treated for chlamydial infection whenever they next seek medical care within the following 3–12 months, regardless of whether the patient believes that her sex partners were treated.

Gonorrhea

  • The USPSTF recommends routine screening for gonorrhea in high-risk women.
  • As with chlamydia, there is no optimal interval defined for screening.

References:

USPSTF on Chlamydia screening
http://www.ahrq.gov/clinic/uspstf/uspschlm.htm

USPSTF on Gonorrhea screening
http://www.ahrq.gov/clinic/uspstf/uspsgono.htm

CDC guideline on STD treatment
http://www.cdc.gov/std/treatment/

 

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