STI Screening

A Practical Reference for Integrating
STI Testing Into Your Practice 

Regular STI screening not only aids in early detection but also plays a significant role in preventing the transmission of STIs by identifying and treating infections in asymptomatic individuals. To learn more, see this wall chart from the CDC.

Chlamydia and Gonorrhea Screening

  • NAT testing of chlamydia and gonorrhea should be performed for any patient presenting with symptoms of abnormal discharge, excessive genital itching/irritation, or burning pain with urination or in the rectum.1

  • All anatomical sites that have had a potential of exposure should be tested (nasopharynx, urethra/urine, rectum).1

  • The United States Preventive Services Taskforce (USPSTF) recommends that sexually active women younger than the age of 25, and women older than the age of 25 with increased risk of infection, and transgender men (regardless of pregnancy status) should get screened for chlamydia and gonorrhea. Testing should be performed yearly, unless risk or symptoms warrant more frequent testing (every 3-6 months).2

  • Pregnant individuals should get tested for chlamydia and gonorrhea at baseline and during the 3rd trimester for those under the age of 25.1

  • Young heterosexual men, men who have sex with men, and transgender women should be screened for chlamydia and gonorrhea based on risk and symptoms. More frequent testing (3-6 months) may be indicated if there is increased risk.1

  • Persons living with HIV should get tested for chlamydia and gonorrhea at the initial medical visit and yearly thereafter. More frequent testing (3-6 months) may be indicated if there is increased risk.1

Syphilis Screening

  • Screening for syphilis infection should be performed for any patient presenting with symptoms of chancre, new rash (especially palms of hands, soles of feet, or trunk), condyloma, and/or fever, headaches, weight loss, fatigue.1

  • The USPSTF recommends that syphilis screening should be performed for all nonpregnant people who are at increased risk for infection and do not have symptoms.3

  • Pregnant persons should be tested for syphilis at first prenatal visit and retested at 28 weeks, and at delivery if there is increased risk. For example, diagnosis of an STI in the last 12 months, high prevalence in geographic area, presence of symptoms, etc..1,2

  • Men who have sex with men and transgender women should be screened annually for syphilis or every 3-6 months if patient is at increased risk for infection.1

  • Persons living with HIV should get tested for syphilis at first HIV evaluation and at least yearly thereafter. More frequent testing might be indicated based on risk factors.1

  • Those with a history of syphilis infection should be evaluated for active infection by checking for adequate changes in the RPR titer. See “For More Information” below for CDC Laboratory Recommendations for Syphilis Testing.

What is DoxyPEP?

  • DoxyPEP is a biomedical STI prevention method that involves taking the antibiotic doxycycline after sex, to prevent chlamydia, syphilis, and gonorrhea infection. 4
  • DoxyPEP is recommended for MSM and transgender women who have been diagnosed with at least one bacterial STI in the last 12 months.
  • CDC’s published clinical guidelines for DoxyPEP can be found on their website at bit.ly/4ccHsWa

For More Information

References

1. Centers for Disease Control and Prevention. (2021). STI screening recommendations. Centers for Disease Control and Prevention; U.S. Department of Health and Human Services.
cdc.gov/std/treatment-guidelines/screening-recommendations.htm

2. United States Preventive Services Task Force. (2021). Chlamydia and Gonorrhea: Screening. U.S. Preventive Services Task Force.
uspreventiveservicestaskforce.org/uspstf/recommendation/chlamydia-and-gonorrhea-screening

3. United States Preventive Services Task Force. (2022). Syphilis infection in nonpregnant adolescents and adults: Screening. U.S. Preventive Services Task Force.
uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-nonpregnant-adults-adolescents-screening

4. Centers for Disease Control and Prevention. (2024a). CDC clinical guidelines on the use of doxycycline postexposure prophylaxis for bacterial sexually transmitted infection prevention, United States, 2024. In Centers for Disease Control and Prevention. Centers for Disease Control and Prevention.
bit.ly/4ccHsWa

FOR MORE HELP, CALL THE HEALTH INFORMATION HELPLINE AT 215-985-2437

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This site contains STI & HIV prevention messages that might not be appropriate for all audiences. Since these infections are spread primarily through sexual practices or by sharing needles, prevention messages may address these topics. If you are not seeking such information or may be offended by such materials, please leave this website.



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