Testing Recommendations

The chart below summarizes recommendations regarding screening for sexually transmitted infections from three organizations: the American Congress of Obstetricians and Gynecologists (ACOG), the U.S. Preventive Services Task Force (USPSTF), and the Centers for Disease Control and Prevention (CDC).

American Congress of Obstetricians and Gynecologists (ACOG)

  • Annual Screening for sexually active females age 25 and younger
  • Screening for women over age 25 with risk factors (e.g., new/multiple partners)
U.S. Preventive Services Task Force (USPSTF)

  • Screening for all sexually active non-pregnant females age 24 and younger. The optimal interval for screening this population is not known; noted that CDC recommends annually.
  • Screening for all pregnant women ages 24 and younger, and pregnant women over 24 who have risk factors (e.g., new sexual partner, unprotected sex, STI history).
    • Insufficient evidence to recommend screening in males.
Centers for Disease Control and Prevention (CDC)

  • All pregnant women
  • Annual testing for all sexually active women under age 26
  • Women 26 and older women with risk factors (new or multiple sex partners)
  • No routine testing for men, but consider screening men in high-prevalence settings (correctional facilities, STD clinics)
American Congress of Obstetricians and Gynecologists (ACOG)

  • Annual Screening for sexually active females age 25 and younger
  • Screening for women over age 25 with risk factors (e.g., new/multiple partners)
U.S. Preventive Services Task Force (USPSTF)

  • All sexually active females, including those who are pregnant, if they have risk factors (similar to those with chlamydia)
  • Insufficient evidence to recommend routine screening for males
Centers for Disease Control and Prevention (CDC)

  • Pregnant women with risk factors (see chlamydia)
  • Wide screening is not recommended
  • argeted screening of women under age 26 at increased risk is prime component of gonorrhea control in the U.S.
  • Screen sexually active MSM annually for: urethral gonorrhea if insertive sex; rectal gonorrhea if receptive anal sex, pharyngeal gonorrhea if performed oral sex
American Congress of Obstetricians and Gynecologists (ACOG)

  • Adolescents should be tested if risk factors are present
U.S. Preventive Services Task Force (USPSTF)

  • Persons at increased risk (MSM, commercial sex work, unprotected sex, those in correctional facilities)
  • All pregnant women
  • The Task Force makes no recommendation on routine screening of men and non-pregnant women not at increased risk for infection
Centers for Disease Control and Prevention (CDC)

  • All pregnant women
  • All sexually active MSM
American Congress of Obstetricians and Gynecologists (ACOG)

  • No specific population guidelines
U.S. Preventive Services Task Force (USPSTF)

  • The Task Force does not recommend routine screening in asymptomatic adolescents and adults, including pregnant women.
Centers for Disease Control and Prevention (CDC)

  • Evidence does not support screening pregnant women for HSV-2
American Congress of Obstetricians and Gynecologists (ACOG)

  • Pregnant women
  • Infants born to infected mothers
  • Sex partners of (and those living with) HBV+ persons
  • HIV+ persons
  • Injecting drug users
  • MSM
  • Healthcare workers with occupational exposure
  • Those treated with immunosuppressive drugs
U.S. Preventive Services Task Force (USPSTF)

  • Pregnant women at their first prenatal visit
  • The Task Force does not recommend routine screening for the asymptomatic general population
Centers for Disease Control and Prevention (CDC)

  • Routine screening of all pregnant women
  • Sexually-active MSM
  • Pre-vaccination screening an option for household, sexual, and needle-sharing contacts of HBV+ persons (to save costs of needless immunization)
American Congress of Obstetricians and Gynecologists (ACOG)

  • HIV+
  • Injecting drug users
  • Those receiving clotting factors before 1987
  • Dialysis patients
  • Abnormal liver enzyme tests
  • Blood transfusion before 1992
  • Healthcare workers with occupational exposure
U.S. Preventive Services Task Force (USPSTF)

  • The Task Force does not recommend routine screening for the asymptomatic general population.
  • Insufficient evidence to recommend for or against routine screening for those with risk factors
Centers for Disease Control and Prevention (CDC)

  • All persons with HIV should be tested
  • Those with a history of injection drug use
  • Routine testing of MSM should be considered.
American Congress of Obstetricians and Gynecologists (ACOG)

  • Women and men ages 19-64
  • Pregnant women and those in other age groups who have risk factors
U.S. Preventive Services Task Force (USPSTF)

  • All adolescents and adults at increased risk for infection (MSM, unprotected sex and multiple partners, commercial sex workers, injection drug users, blood transfusion between 1978 and 1985).
  • The Task Force makes no recommendation for screening those without risk factors.
Centers for Disease Control and Prevention (CDC)

  • HIV screening for patients ages 13-64 in all healthcare settings
American Congress of Obstetricians and Gynecologists (ACOG)

  • Begin at age 21
  • Under 30, Pap every two years
  • 30 and over, Pap every three years with interval extended to three years following three consecutive, normal tests
U.S. Preventive Services Task Force (USPSTF)

  • Cytology in women ages 21-65 every three years
Centers for Disease Control and Prevention (CDC)

  • Summarized cervical cancer screening guidelines publishd by ACS, ACOG, and ASCCP
American Congress of Obstetricians and Gynecologists (ACOG)

  • Women 30 and older may be tested with cytology alone or HPV/Pap co-testing
U.S. Preventive Services Task Force (USPSTF)

  • Women ages 30-65 who wish to extend screening intervals may use Pap/HPV co-test every five years
Centers for Disease Control and Prevention (CDC)

  • Triage  for women 21 and older with ASC-US cytology. HPV/Pap co-testing in women 30+ years of age
American Congress of Obstetricians and Gynecologists (ACOG)

  • ACOG endorses ACIP recommendations for HPV vaccination in girls and young women: routine for ages 11-12 with catch-up for ages 13-26
U.S. Preventive Services Task Force (USPSTF)

  • No population-specific guidance
Centers for Disease Control and Prevention (CDC)

  • ACIP recommendations for HPV vaccination in girls and young women: routine for ages 11-12 with catch-up for ages 13-26. Routine use for males ages 11-12 with catch-up for ages 13-21.