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Does it benefit you to get a screening test for chlamydia and gonorrhea?

Does it benefit you to get a screening test for chlamydia and gonorrhea?

Last Reviewed : 01/05/2021
Does it benefit you to get a screening test for chlamydia and gonorrhea?

Gonorrhea and chlamydia are the most commonly reported sexually transmitted infections (STI) in the United States. Well, there are nearly 1.4 million cases of chlamydia and 330,000 cases of gonorrhea reported in 2012 by the Centers for Disease Control and Prevention (CDC). In women of reproductive age, chlamydia is ten times more prevalent than gonorrhea infection. Most of the chlamydia and gonorrhea infections are asymptomatic and remain undiagnosed for longer periods until they develop severe complications. About 800,000 new infections of gonorrhea occur every year, but only a few of them are diagnosed and reported, according to the CDC .

Complications and Risk Factors

Asymptomatic chlamydia and gonorrhea infection can lead to a lot of severe complications like pelvic inflammatory disease. On the other hand, these complications result in chronic pelvic pain, ectopic pregnancy, and infertility. Infants born to women with untreated infection may develop chlamydial pneumonia, gonorrhea, or chlamydial ophthalmia. These two infections are also associated with an increased risk of HIV infection. So, if screening is used to diagnose asymptomatic disease, we can prevent and treat such complications.

Risk factors for sexually transmitted infection include new sex partner, multiple partners, sex partner with concurrent partners, partner with an STI, irregular condom use, and previous history of STI. STI prevalence is higher in military recruits, incarcerated populations, and in patients receiving care at public STI clinics.

Screening

Due to its high sensitivity and specificity, screening for chlamydia and gonorrhea is performed using the Nucleic Acid Amplification Test (NAAT). NAAT is approved by the U.S. Food and Drug Administration (FDA) for use on urogenital sites and male and female urine. Samples from the endocervix, the vagina and male urethra (collected by the physician) can also be used to make a diagnosis with NAAT. Although it is not approved by the FDA, rectal and pharyngeal swabs are also mostly collected from individuals who practice oral and anal sex. An interesting fact is that the same sample can be used to test for both gonorrhea and chlamydia. Once diagnosed, gonorrhea and chlamydia can be treated with antibiotics. The CDC has laid down a few guidelines for treating sexually transmitted infections promptly and effectively.

In a similar vein, the U.S. Preventive Services Task Force makes recommendations about the effectiveness of specific screening of disease in individuals with risk factors but no related signs and symptoms based on the balance between harm and benefits of the screening. The USPSTF found shreds of evidence that screening tests can be used to detect both chlamydia and gonorrhea accurately.

 

Final Word

The Task Force findings suggest that screening reduces complications of chlamydia and gonorrhea infection in women at increased risk, with a moderate magnitude of benefit. However, the USPSTF was unable to find adequate evidence that screening for infection reduces complications of infection or transmission of either disease or HIV in men. USPSTF found pieces of evidence that there was less or no harm in screening for chlamydia or gonorrhea infections in women.

The Task Force concludes - with moderate certainty - that chlamydia and gonorrhea screening is associated with moderate benefit in all sexually active women of age 24 years or less and in older women with increased risk of infection. It also added that there is insufficient evidence to assess the balance between harm and benefit of screening for chlamydia and gonorrhea in men.

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