Table 5. Examples of Screening Strategies to Detect
Asymptomatic Sexually Transmitted or Blood-Borne Infections
First visit
All patients
>> Serologic test for syphilis (ie, nontreponemal test, such as RPR or VDRL)
>> Consider urine-based (first-void specimen) NAAT for gonorrhea
>> Consider urine-based (first-void specimen) NAAT for Chlamydia species
>> Serologic tests for hepatitis B and C (If hepatitis B negative, vaccinate)
Women
>> Examination of vaginal secretions for Trichomonas species
>> Cervical specimen for NAAT for Chlamydia species for all sexually active women
aged ≤ 25 and other women at increased risk
Patients reporting receptive anal sex
>> Culture of rectal sample for Neisseria gonorrhoeae
>> Culture of rectal sample for Chlamydia species
Patients reporting receptive oral sex: culture of pharyngeal sample for N. gonorrhoeae
Subsequent visits
All sexually active patients: screening tests for STDs should be repeated at least annually
Asymptomatic persons at higher risk
>> More frequent periodic screening (eg, at 3-month to 6-month intervals) if any of
the following factors are present
▶ Multiple or anonymous sex partners
▶ Past history of any STD
▶ Identification of other behaviors associated with transmission of HIV and other STDs
▶ Sex or needle-sharing partner(s) with any of the above-mentioned risks
▶ Developmental changes in life that may lead to behavioral change with increased
risky behavior (eg, dissolution of a relationship)
▶ High prevalence of STDs in the area or in the patient population
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