CDC guidelines for sexually transmitted infection (STI) screening

The following guide for sexually transmitted infection screening is adapted from the Centers for Disease Control and Prevention.

The following guide for sexually transmitted infection (STI)/sexually transmitted disease (STD) screening is adapted from the Centers for Disease Control and Prevention (CDC).

Chlamydia

Assigned female at birth

  • Sexually active under 25 years of age
  • Sexually active ages 25 years and older if at increased risk (Those who have a new sex partner, more than one sex partner, a sex partner with concurrent partners or a sex partner who has a sexually transmitted infection.)
  • If infected retest approximately three months after treatment

If pregnant

  • All under 25 years of age
  • Ages 25 and older if at increased risk
  • Retest during the third trimester for those under 25 years of age or at risk
  • If there is chlamydial infection while pregnant, the patient should have a test-of-cure three to four weeks after treatment and be retested within three months.

Assigned male at birth

Not a formal CDC recommendation: Consider screening young patients in high prevalence clinical settings (adolescent clinics, correctional facilities and STD clinics, for example) or in populations with high burden of infection (men who have sex with men, for example)

Men who have sex with men

  • At least annually for sexually active men who have sex with men at sites of contact (urethra, rectum) regardless of condom use
  • Every three to six months if at increased risk (More frequent STD screening — for syphilis, gonorrhea and chlamydia for example, including those with HIV infection if risk behaviors persist or if they or their sexual partners have multiple partners.)

Persons with HIV

  • For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter.
  • More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology.

Gonorrhea

Assigned female at birth

  • Sexually active under age 25.
  • Sexually active ages 25 and older if at increased risk (Those who have a new sex partner, more than one sex partner, a sex partner with concurrent partners or a sex partner who has an STI.)
  • Retest three months after treatment.

If pregnant

  • All under age 25 and those older if at increased risk.
  • Retest three months after treatment.

Men who have sex with men

  • At least annually for sexually active men who have sex with men at sites of contact (urethra, rectum, pharynx) regardless of condom use
  • Every three to six months if at increased risk (More frequent STD screening — for syphilis, gonorrhea and chlamydia for example, including those with HIV infection, if risk behaviors persist or if they or their sexual partners have multiple partners.)

Persons with HIV

  • For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter.
  • More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology.

Syphilis

If pregnant

Men who have sex with men

  • At least annually for sexually active men who have sex with men.
  • Every three to six months if at increased risk (More frequent STD screening — for syphilis, gonorrhea and chlamydia for example, including those with HIV infection, if risk behaviors persist or if they or their sexual partners have multiple partners.)

Persons with HIV

  • For sexually active individuals, screen at first HIV evaluation, and at least annually thereafter.
  • More frequent screening might be appropriate depending on individual risk behaviors and the local epidemiology.

Trichomonas

Assigned female at birth

Not a formal CDC recommendation: Consider for patients receiving care in high-prevalence settings (e.g., STD clinics and correctional facilities) and for those at high risk for infection (e.g., with multiple sex partners, exchanging sex for payment, illicit drug use, and a history of STD).

Persons With HIV

  • Recommended for those sexually active at entry to care and at least annually thereafter

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HIV

Assigned female at birth

  • All ages 13 to 64 years unless the patient declines. The U.S. Preventive Services Task Force (USPSTF) recommends screening in adults and adolescents ages 15 to 65.
  • All patients who seek evaluation and treatment for STDs

If pregnant

  • All pregnant patients should be screened at first prenatal visit unless the patient declines.
  • Retest in the third trimester if at high risk (Patients who use illicit drugs, have STDs during pregnancy, have multiple sex partners during pregnancy, live in areas with high HIV prevalence, or have partners with HIV infection.)

Assigned male at birth

  • All men ages 13 to 64 unless the patient declines. The USPSTF recommends screening in adults and adolescents ages 15 to 65.
  • All patients who seek evaluation and treatment for STDs

Men who have sex with men

  • At least annually for sexually active men who have sex with men if HIV status is unknown or negative and the patient or patient’s sex partner(s) have had more than one sex partner since most recent HIV test

Cervical cancer

Assigned female at birth

  • Ages 21 to 29, every three years with cytology
  • Ages 30 to 65 every three years with cytology, or every five years with a combination of cytology and HPV testing

If pregnant

  • Should be screened at same intervals as nonpregnant patients

Persons with HIV

  • Should be screened within one year of sexual activity or initial HIV diagnosis using conventional or liquid-based cytology; testing should be repeated six months later

Hepatitis B screening

Assigned female at birth

  • Those at increased risk — persons born in regions of high endemicity (greater than or equal to% prevalence), injecting drug users, men who have sex with men, persons on immunosuppressive therapy, hemodialysis patients, HIV-positive individuals, and others. More information.

If pregnant

  • Test for HBsAg at first prenatal visit of each pregnancy regardless of prior testing; retest at delivery if at high risk.

Assigned male at birth

  • Those at increased risk — persons born in regions of high endemicity (greater than or equal to% prevalence), injecting drug users, men who have sex with men, persons on immunosuppressive therapy, hemodialysis patients, HIV-positive individuals, and others. More information.

Men who have sex with men

  • All men who have sex with men should be tested for HBsAg

Persons with HIV

  • Test for HBsAg and anti-HBc and/or anti-HBs

Hepatitis C screening

Universal hepatitis C screening

At least once in a lifetime for all adults ages 18 and older.

Hepatitis C (HCV) screening for all pregnant women during each pregnancy.

One‑time hepatitis C testing regardless of age

  • People with HIV
  • People who ever injected drugs and shared needles, syringes, or other drug preparation equipment, including those who injected once or a few times many years ago
  • People with selected medical conditions, including:
    • Ever received maintenance hemodialysis
    • Persistently abnormal alanine transaminase (ALT) levels
  • Prior recipients of transfusions or organ transplants, including:
    • Received clotting factor concentrates produced before 1987
    • Received a transfusion of blood or blood components before July 1992
    • Received an organ transplant before July 1992
    • Notified that they received blood from a donor who later tested positive for HCV infection
  • Health care, emergency medical, and public safety personnel after needle sticks, sharps, or mucosal exposures to HCV‑positive blood
  • Children born to mothers with HCV infection

Routine periodic testing for people with ongoing risk factors, while risk factors persist

  • Those who currently inject drugs and share needles, syringes, or other drug preparation equipment
  • Selected medical conditions, including:
    • Ever received maintenance hemodialysis

Anyone who requests hepatitis C testing should receive it

  • Some may not disclose risk due to concerns over stigmatization.

Reviewed by Jessica R. Stumbo, M.D., internal medicine/pediatrics physician at Norton Community Medical Associates – LaGrange.


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