9
Screening and Vaccination for Infectious Diseases
Screening for Chlamydia, Gonorrhea, Trichomoniasis
50. Screening for syphilis, chlamydia, and gonorrhea in asymptomatic
persons should be repeated at least annually after initial screening,
or every 3–6 months depending on sexual activities, presence of
other STIs in the patient or their partner, and local community STI
prevalence.
51. All persons having vaginal sex should be screened for trichomoniasis
annually.
52. Tailored messages are critical for patients who report persistent
high-risk behavior or who have symptoms or signs of STIs. In nearly
all situations, the provider should offer brief counseling. In general,
persons exhibiting ongoing risk behavior should also be referred to
programs capable of offering more extensive intervention programs.
Screening and Vaccination for Other Infectious Diseases
53. Perform tuberculosis screening annually in persons at risk for
infection. (See Section II)
54. Repeat testing is recommended in patients with advanced HIV
disease who initially had negative TST or IGRA results but
subsequently experienced an increase in the CD4 cell count to
>200 cells/µL on ART and who may thus have developed sufficient
immunocompetence to mount a positive reaction.
55. Vaccinations for pneumococcal infection, influenza, tetanus-
diphtheria-whooping cough, and meningococcus should be offered
according to CDC Opportunistic Infection and ACIP guidelines.
56. Asymptomatic persons with CD4 >200 cells/mm
3
who are traveling
internationally should receive required vaccinations including live
vaccines.
