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Adolescents have the highest prevalence rates for many sexually transmitted infections (STIs). Early detection of nonviral STIs facilitates treatment, prevents transmission, and avoids complications.
Chlamydia, gonorrhea, and syphilis screening guidelines from the US Preventive Services Task Force and the Centers for Disease Control and Prevention recommend screening those at risk based on epidemiologic and clinical outcomes data. This American Academy of Pediatrics (AAP) policy statement regarding these curable, nonviral STIs summarizes the evidence for nonviral STI screening in adolescents, discusses the value of screening, and offers recommendations for routine screening of adolescents for nonviral STIs.
The AAP has recommended routine laboratory screening for nonviral STIs in some adolescents and young adults in a policy statement published online June 30 in Pediatrics.
The AAP's Committee on Adolescence and Society for Adolescent Health and Medicine developed the policy statement and recommendations "to identify and treat individuals with treatable infections, reduce transmission to others, avoid or minimize long-term consequences, identify other exposed and potentially infected individuals, and decrease the prevalence of infection in a community."
Although prevalence rates of some STIs are highest among adolescents, nonviral STIs can be treated and transmission to others eliminated if they are caught early, the authors write. The US Preventive Services Task Force and the Centers for Disease Control and Prevention have published similar guidelines.
The AAP recommendations cover chlamydia, gonorrhea, trichomoniasis, and syphilis.
Specifically, the academy recommends routine laboratory screening for chlamydia:
The academy recommends routine laboratory screening for gonorrhea:
The academy recommends against routine screening of asymptomatic adolescents for trichomoniasis but suggests that this screening may be necessary for female adolescents and young adults who have new or multiple partners, have a history of STIs, exchange sex for money, or inject drugs.
The academy recommends against routine screening for syphilis in nonpregnant, heterosexual adolescents but recommends screening for all sexually active adolescent and young adult MSM annually or every 3 to 6 months if at high risk. It also recommends the following:
"Pediatricians can take an active role in reducing disease prevalence and adverse sequelae by identifying and treating undiagnosed infections," the authors write.
Pediatrics. Published online June 30, 2014. Abstract