Urethritis screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]


Overview

High risk individual in specific conditions needs to be screened for sexually transmitted diseases. The U.S. Preventive Service Task Force (USPSTF) developed the recommendation for this screening.

Screening

According to the U.S. Preventive Service Task Force (USPSTF), screening for sexually transmitted disease is recommended as outlines below for Chlamydia Trachomatis and N. Gonorrhea[1][2].


Chlamydia Trachomatis

Population Recommendations
Women
  • Sexually active women under 25 years of age
  • Sexually active women age 25 years and older if at increased risk
    • Prior history of sexually transmitted infection
    • A new sex partner
    • More than one sex partner
    • A sex partner with concurrent partners
    • A sex partner who has a sexually transmitted infection
  • Retest 3 months after treatment.
Men
  • Consider screening young men in high prevalence clinical settings or in populations with high burden of infection(e.g.Men who have sex with men)
Pregnant women
  • All pregnant women under 25 years of age
  • Pregnant women, aged 25 and older if at increased risk
  • Retest during the 3rd trimester for women under 25 years of age or at risk
  • Pregnant women with chlamydial infection should have a test-of-cure 3-4 weeks after treatment and be retested within 3 months
Men Who have Sex With Men (MSM)
  • At least annually for sexually active MSM at sites of contact (urethra, rectum) regardless of condom use
  • Every 3 to 6 months if at increased risk
HIV positive patients
  • For sexually active individuals, screen at first HIV evaluation, and at least annually
  • More frequent screening may be indicated depending on individual risk behaviors and the local epidemiology

N. Gonorrhea

Population Recommendations
Women
  • Sexually active women under 25 years of age
  • Sexually active women age 25 years and older if at increased risk
    • Prior history of sexually transmitted infection
    • A new sex partner
    • More than one sex partner
    • A sex partner with concurrent partners
    • A sex partner who has a sexually transmitted infection
  • Retest 3 months after treatment.
Men Who have Sex With Men (MSM)
  • At least annually for sexually active MSM at sites of contact (urethra, rectum, pharynx) regardless of condom use
  • Every 3 to 6 months if at increased risk
Pregnant women
  • All pregnant women under 25 years of age and older women if at increased risk
  • Retest 3 months after treatment
HIV positive patients
  • For sexually active individuals, screen at first HIV evaluation, and at least annually
  • More frequent screening may be indicated depending on individual risk behaviors and the local epidemiology

References

  1. Screening recommendation for chlamydia. UPSTF. http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/chlamydia-and-gonorrhea-screening?ds=1&s=chlamydia(2014). Acessed on September 28, 2016
  2. US preventive services task forces. Gonorrhea and chlamydia screening (2014) https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/chlamydia-and-gonorrhea-screening Accessed on September 28, 2016

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