Health-Care Professionals

Screening recommendations for asymptomatic individuals

**Table 3. Screening Recommendations for Asymptomatic Individuals**
Who	Which	When	What
Females	Age = 20 years and sexually active	All visits	CT, PID
	Known contact with STI, multiple partners, new partner or > 2 sexual partners in last 2 months	All visits	CT, PID, GC, HPV, HSV
	Pregnant	Pre-natal assessment	CT, HBV, HIV, GC, Syphilis
	IDU or commercial sex worker	All visits	CT, GC, PID, HPV, HSV, HBV, HIV
	Immigrants or travelers from countries with epidemic STIs	All visits	CT, PID, GC, Consider syphilis, HAV, HBV and HIV
Males	Age = 24 years and sexually active	All visits	Consider 1st void urine for CT
	Known contact with STD, multiple partners, new partner or > 2 sexual partners in last 2 months	All visits	Urine CT, GC, HSV, HBV
	IDU, street involvement, commercial sex worker or men who have sex with men	All visits	Urine CT, GC, HIV, HBV
	Immigrants or travelers from countries with epidemic STIs	All visits	Urine CT, GC, Consider syphilis, HAV, HBV and HIV

Chlamydia screening is recommended for most groups because the infection is highly prevalent and commonly sub-clinical or asymptomatic (females 60-80%, males 50-60%), sequelae are serious and frequent (particularly in women) and nucleic acid amplification tests such as LCR (ligase chain reaction) are now widely available, sensitive and simple to perform. Although chlamydia screening in males is not widely proposed, nucleic acid amplification testing on first-voided urines is now well accepted and simple to carry out.

Screening for gonorrhea is less widely recommended due to its declining incidence and a less frequent asymptomatic presentation. Screening for other STIs requires phlebotomy for serology (syphilis, HBV, HIV) or the presence of active lesions to sample (HSV, HPV). HPV screening with colposcopy and aceto-whitening should only be carried out by those with experience in these techniques.